Overview of Fluid Dynamics Activities at the Marshall Space Flight Center

NASA Technical Reports Server (NTRS)

Garcia, Roberto; Griffin, Lisa W.; Wang, Ten-See

1999-01-01

Since its inception 40 years ago, Marshall Space Flight Center (MSFC) has had the need to maintain and advance state-of-the-art flow analysis and cold-flow testing capability to support its roles and missions. This overview discusses the recent organizational changes that have occurred at MSFC with emphasis on the resulting three groups that form the core of fluid dynamics expertise at MSFC: the Fluid Physics and Dynamics Group, the Applied Fluid Dynamics Analysis Group, and the Experimental Fluid Dynamics Group. Recently completed activities discussed include the analysis and flow testing in support of the Fastrac engine design, the X-33 vehicle design, and the X34 propulsion system design. Ongoing activities include support of the RLV vehicle design, Liquid Fly Back Booster aerodynamic configuration definition, and RLV focused technologies development. Other ongoing activities discussed are efforts sponsored by the Center Director's Discretionary Fund (CDDF) to develop an advanced incompressible flow code and to develop optimization techniques. Recently initiated programs and their anticipated required fluid dynamics support are discussed. Based on recent experiences and on the anticipated program needs, required analytical and experimental technique improvements are presented. Due to anticipated budgetary constraints, there is a strong need to leverage activities and to pursue teaming arrangements in order to advance the state-of-the-art and to adequately support concept development. Throughout this overview there is discussion of the lessons learned and of the capabilities demonstrated and established in support of the hardware development programs.

Technology development for lunar base water recycling

NASA Technical Reports Server (NTRS)

Schultz, John R.; Sauer, Richard L.

1992-01-01

This paper will review previous and ongoing work in aerospace water recycling and identify research activities required to support development of a lunar base. The development of a water recycle system for use in the life support systems envisioned for a lunar base will require considerable research work. A review of previous work on aerospace water recycle systems indicates that more efficient physical and chemical processes are needed to reduce expendable and power requirements. Development work on biological processes that can be applied to microgravity and lunar environments also needs to be initiated. Biological processes are inherently more efficient than physical and chemical processes and may be used to minimize resupply and waste disposal requirements. Processes for recovering and recycling nutrients such as nitrogen, phosphorus, and sulfur also need to be developed to support plant growth units. The development of efficient water quality monitors to be used for process control and environmental monitoring also needs to be initiated.

78 FR 16257 - Notice of Intent To Prepare the Commonwealth of the Northern Mariana Islands Joint Military...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-14

... uninterrupted schedule. These RTAs are needed to support ongoing operational requirements, changes to U.S. force.... MARFORPAC, as the Executive Agent, has invited the Federal Aviation Administration (FAA); International...., Dandan Elementary School Cafeteria, Dandan Road, Dandan, Saipan, CNMI 96960 Thursday, April 11, 2013, 4...

Assessment of a Multinational Online Faculty Development Program on Online Teaching: Reflections of Candidate E-Tutors

ERIC Educational Resources Information Center

Adnan, Muge; Kalelioglu, Filiz; Gulbahar, Yasemin

2017-01-01

Teaching online requires different skills, roles and competencies for online instructors compared to teaching in traditional learning environments. Universities should offer ongoing support in various forms to help academic staff through their online journey. This paper provides insights into a multinational faculty development program for…

Self-Assessment in Professional Programmes within Tertiary Institutions

ERIC Educational Resources Information Center

Bourke, Roseanna

2014-01-01

Self-assessment at tertiary level is a critical pedagogical and assessment tool to support students in their transition to professional careers where on-going learning and assessment is required. Beyond the safety-net of course content, external assessment and pre-determined criteria, novice professionals need to find ways to self-assess their…

Academic Program Review--Concerns and Justification.

ERIC Educational Resources Information Center

Heldman, D. R.

Academic program review should not be considered a new phenomenon in higher education; reviews of various types have been conducted on a continuing basis. The renewed importance of an organized effort has been stimulated by the inability of funding sources to maintain levels of support required to insure quality in all on-going programs. Current…

Actuarial Science at One Four-Year Comprehensive University

ERIC Educational Resources Information Center

Charlwood, Kevin E.

2014-01-01

Building an Actuarial Science program designated as advanced requires dedicated faculty, support from the administration, and a core group of strong students. Washburn University may serve as a model for those wishing to start or enhance such a program at their institution. We face three main ongoing challenges: first, the hiring and retention of…

EVA Communications Avionics and Informatics

NASA Technical Reports Server (NTRS)

Carek, David Andrew

2005-01-01

The Glenn Research Center is investigating and developing technologies for communications, avionics, and information systems that will significantly enhance extra vehicular activity capabilities to support the Vision for Space Exploration. Several of the ongoing research and development efforts are described within this presentation including system requirements formulation, technology development efforts, trade studies, and operational concept demonstrations.

Identification and status of design improvements to the NASA Shuttle EMU for International Space Station application.

PubMed

Wilde, R C; McBarron, J W; Faszcza, J J

1997-06-01

To meet the significant increase in EVA demand to support assembly and operations of the International Space Station (ISS), NASA and industry have improved the current Shuttle Extravehicular Mobility Unit (EMU), or "space suit", configuration to meet the unique and specific requirements of an orbital-based system. The current Shuttle EMU was designed to be maintained and serviced on the ground between frequent Shuttle flights. ISS will require the EMUs to meet increased EVAs out of the Shuttle Orbiter and to remain on orbit for up to 180 days without need for regular return to Earth for scheduled maintenance or refurbishment. Ongoing Shuttle EMU improvements have increased reliability, operational life and performance while minimizing ground and on-orbit maintenance cost and expendable inventory. Modifications to both the anthropomorphic mobility elements of the Space Suit Assembly (SSA) as well as to the Primary Life Support System (PLSS) are identified and discussed. This paper also addresses the status of on-going Shuttle EMU improvements and summarizes the approach for increasing interoperability of the U.S. and Russian space suits to be utilized aboard the ISS.

Building Geographic Information System Capacity in Local Health Departments: Lessons From a North Carolina Project

PubMed Central

Miranda, Marie Lynn; Silva, Jennifer M.; Overstreet Galeano, M. Alicia; Brown, Jeffrey P.; Campbell, Douglas S.; Coley, Evelyn; Cowan, Christopher S.; Harvell, Dianne; Lassiter, Jenny; Parks, Jerry L.; Sandelé, Wanda

2005-01-01

State government, university, and local health department (LHD) partners collaborated to build the geographic information system (GIS) capacity of 5 LHDs in North Carolina. Project elements included procuring hardware and software, conducting individualized and group training, developing data layers, guiding the project development process, coordinating participation in technical conferences, providing ongoing project consultation, and evaluating project milestones. The project provided health department personnel with the skills and resources required to use sophisticated information management systems, particularly those that address spatial dimensions of public health practice. This capacity-building project helped LHDs incorporate GIS technology into daily operations, resulting in improved time and cost efficiency. Keys to success included (1) methods training rooted in problems specific to the LHD, (2) required project identification by LHD staff with associated timelines for development, (3) ongoing technical support as staff returned to home offices after training, (4) subgrants to LHDs to ease hardware and software resource constraints, (5) networks of relationships among LHDs and other professional GIS users, and (6) senior LHD leadership who supported the professional development activities being undertaken by staff. PMID:16257950

Social-support needs among adolescents living with HIV in transition from pediatric to adult care in Cambodia: findings from a cross-sectional study.

PubMed

Toth, Graham; Mburu, Gitau; Tuot, Sovannary; Khol, Vohith; Ngin, Chanrith; Chhoun, Pheak; Yi, Siyan

2018-03-28

Understanding the circumstances of adolescents living with HIV is critical in designing adolescent-friendly services that will facilitate successful transition from pediatric to adult care. This study describes access, utilization and ongoing social support needs among adolescents living with HIV aged 15-17 in transition from pediatric to adult HIV care in Cambodia. A cross-sectional study was conducted among 328 adolescents, randomly selected from 11 antiretroviral therapy (ART) clinics across the country. Descriptive analyses were conducted to summarize their characteristics, access to social support and ongoing support needs among male and female adolescents. Mean age of the study participants was 15.8 (SD = 0.8) years. Just over half (55.2%) were male. Most had at least one deceased parent (mother 50.9%; father 60.5%), and majority were living with biological parents (40.8%) or relatives (49.3%). A third came from families with an ID poor card, and 21.0% were working for pay. Almost half (46.6%) reported that their family had received social support for their health care, including food support (76.5%), school allowance (62.1%), transport allowance to ART clinics (53.6%), psychosocial counseling (35.3%), vocational training (22.9%) or home visits (11.1%). Several ongoing social support needs were identified, including ongoing inability to cover health expenses unless they are supported by health insurance or health equity fund (55.0%). In addition, adolescents reported having been asked to come back earlier than their scheduled appointment (13.7%), having had to purchase their own drugs (2.7%), experiencing HIV stigma (32.0%), having been denied housing or food due to HIV (8.2%) or failing to attend school within the past month partly because of HIV (16.8%). Two-thirds did not have access to peer support groups. Social protection mechanisms are reaching some adolescents in need, while other remain without social support due to discontinuities in health and social care. Multi-sectoral interventions, supporting school attendance, adolescent-friendly clinic scheduling, reductions in child employment, mitigation of HIV-related stigma and strengthening of peer-to-peer support are required to improve coverage of social protection interventions for adolescents in transition.

Informing or Shaping Public Opinion? The Influence of School Accountability Data Format on Public Perceptions of School Quality

ERIC Educational Resources Information Center

Jacobsen, Rebecca; Snyder, Jeffrey W.; Saultz, Andrew

2014-01-01

The 2001 No Child Left Behind Act requires local education agencies to publicly disseminate school performance data. In response, districts and state departments of education have created "school report cards" that vary widely. While data dissemination policies can improve institutional legitimacy and ensure ongoing support, we suggest…

Digital Advances Reshaping K-12 Testing. Technology Counts, 2014. Education Week. Volume 33 Number 25

ERIC Educational Resources Information Center

Edwards, Virginia B., Ed.

2014-01-01

Figuring out how to use digital tools to transform testing requires a willingness to invest in new technologies and the patience to experiment with novel approaches, a commitment to ongoing professional development and reliable technical support, and an openness to learn from mistakes. Whatever bumpy ride this technological journey takes, experts…

Does a School Social Worker's Gender Matter? The Experience of Pregnant and Parenting Teens

ERIC Educational Resources Information Center

Lucio, Robert; Dixon, Donald M.

2008-01-01

Nearly one million adolescent girls in the United States become pregnant annually, which has significant negative social and economic consequences. The number of teen pregnancies totals 50,000 in Florida, where state statutes require that these adolescents be provided with ongoing education and other support services in schools. While school…

Supporting mentors working with students with intellectual disabilities in higher education.

PubMed

Giust, Amanda M; Valle-Riestra, Diana M

2017-06-01

Project Panther LIFE is an inclusive postsecondary transition program for students with intellectual disabilities providing university access and participation with the primary goal of employment at program completion. Students in the program receive support from their academic mentors and peer coaches during the academic year. This study examines the skills and activities mentors use during their weekly sessions with students with intellectual disabilities and identifies areas in which mentors may require further support or training. Data analysis revealed major themes related to inclusion, self-determination, and adaptive behavior skills. Upon review of the data, we suggest that mentors need ongoing support from transition programs especially in areas related to encouraging self-advocacy and supporting time management.

Ada and software management in NASA: Assessment and recommendations

NASA Technical Reports Server (NTRS)

1989-01-01

Recent NASA missions have required software systems that are larger, more complex, and more critical than NASA software systems of the past. The Ada programming language and the software methods and support environments associated with it are seen as potential breakthroughs in meeting NASA's software requirements. The findings of a study by the Ada and Software Management Assessment Working Group (ASMAWG) are presented. The study was chartered to perform three tasks: (1) assess the agency's ongoing and planned Ada activities; (2) assess the infrastructure (standards, policies, and internal organizations) supporting software management and the Ada activities; and (3) present an Ada implementation and use strategy appropriate for NASA over the next 5 years.

Predicting Students' Attitudes towards Advertising on a University Virtual Learning Environment (VLE)

ERIC Educational Resources Information Center

Ogba, Ike-Elechi; Saul, Neil; Coates, Nigel F.

2012-01-01

Most if not all UK universities and many in other parts of the world support their student learning via a virtual learning environment (VLE). Online resources are going to be increasingly important to students as the internet is very much part of their lives. However, the VLE will require ongoing investment to keep pace with technological…

A Comparison of Educational Systems of Turkey, Malta, Ireland, Spain, Sweden, Portugal, Finland, Greece, Belgium, the Netherlands and Denmark

ERIC Educational Resources Information Center

Gokce, Asiye Toker; Celep, Cevat

2011-01-01

Managing people requires ongoing living in a harmony and to educate citizens who would support this status. It is not easy to continue the existence of management which can perform different cultures. The different management style is different educational systems. The management style also directly affects the country's educational philosophy.…

Getting Education Right for Long-term Growth in the Czech Republic. OECD Economics Department Working Papers, No. 497

ERIC Educational Resources Information Center

Goglio, Alessandro

2006-01-01

Widening the skills base and improving labour-market efficiency requires the support of good education. This paper describes the structure of the education system, identifies weaknesses and considers ways to improve performance in light of the ongoing rapidly expanding demand for tertiary level education. The paper discusses ways to modernise the…

Development of a cell-based treatment for long-term neurotrophin expression and spiral ganglion neuron survival.

PubMed

Zanin, M P; Hellström, M; Shepherd, R K; Harvey, A R; Gillespie, L N

2014-09-26

Spiral ganglion neurons (SGNs), the target cells of the cochlear implant, undergo gradual degeneration following loss of the sensory epithelium in deafness. The preservation of a viable population of SGNs in deafness can be achieved in animal models with exogenous application of neurotrophins such as brain-derived neurotrophic factor (BDNF) and neurotrophin-3. For translation into clinical application, a suitable delivery strategy that provides ongoing neurotrophic support and promotes long-term SGN survival is required. Cell-based neurotrophin treatment has the potential to meet the specific requirements for clinical application, and we have previously reported that Schwann cells genetically modified to express BDNF can support SGN survival in deafness for 4 weeks. This study aimed to investigate various parameters important for the development of a long-term cell-based neurotrophin treatment to support SGN survival. Specifically, we investigated different (i) cell types, (ii) gene transfer methods and (iii) neurotrophins, in order to determine which variables may provide long-term neurotrophin expression and which, therefore, may be the most effective for supporting long-term SGN survival in vivo. We found that fibroblasts that were nucleofected to express BDNF provided the most sustained neurotrophin expression, with ongoing BDNF expression for at least 30 weeks. In addition, the secreted neurotrophin was biologically active and elicited survival effects on SGNs in vitro. Nucleofected fibroblasts may therefore represent a method for safe, long-term delivery of neurotrophins to the deafened cochlea to support SGN survival in deafness. Copyright © 2014 IBRO. Published by Elsevier Ltd. All rights reserved.

Acquisition of Cleanroom Research Equipment to Support Ongoing DoD Programs at ASU

DTIC Science & Technology

2017-12-12

Report: Acquisition of cleanroom research equipment to support ongoing DoD programs at ASU The views, opinions and/or findings contained in this report...documentation. 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS (ES) U.S. Army Research Office P.O. Box 12211 Research Triangle Park, NC 27709...Agreement Number: W911NF-16-1-0354 Organization: Arizona State University Title: Acquisition of cleanroom research equipment to support ongoing DoD

25 CFR 1000.396 - Does a Tribe/Consortium have additional ongoing requirements to maintain minimum standards for...

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 2 2013-04-01 2013-04-01 false Does a Tribe/Consortium have additional ongoing requirements to maintain minimum standards for Tribe/Consortium management systems? 1000.396 Section 1000.396... Miscellaneous Provisions § 1000.396 Does a Tribe/Consortium have additional ongoing requirements to maintain...

Aura Science and Validation

NASA Technical Reports Server (NTRS)

Hilsenrath, E.; Schoeberl, M.; Douglass, A.; Anderson, J.; Bhartia, P. K. (Technical Monitor)

2002-01-01

The EOS-Aura Mission is designed to answer three basic questions concerning the Earth's atmosphere: 1) Is ozone recovering as predicted, 2) is air quality getting worse, and 3) how is climate changing? Aura's four instruments work synergistically and are dedicated to answering these questions. These questions relate to NASA Earth Science Enterprise's overall strategic questions, which seek to understand the consequences of climate change for human civilization and determine if these changes can be predicted. NASA supports an ongoing research and analysis program, which is conducted independently and in support of satellite missions. The research program conducts several on-going field campaigns employing aircraft, balloons, and ground based systems. These campaigns have focused on exploring processes in the tropics, high latitudes, and continental outflow to explain the chemistry and transport in the troposphere and stratosphere and how these regions interact. NASA is now studying how the Aura mission and requirements of the research and analysis program might be merged to achieve its strategic goals related to global atmospheric chemistry changes. In addition, NASA field campaign resources will be folded into Aura's validation requirements. Aura validation requires correlative measurements throughout the troposphere and stratosphere under a range of observing and geophysical conditions. Because of the recent launches of Envisat and other smaller international chemistry satellites, the NASA program plans to collaborate with European space agencies in developing a series of campaigns that will provide continuity between those satellites missions and Aura.

Weighing the Anti-Ischemic Benefits and Bleeding Risks from Aspirin Therapy: a Rational Approach.

PubMed

Dugani, Sagar; Ames, Jeffrey M; Manson, JoAnn E; Mora, Samia

2018-02-21

The role of aspirin in secondary cardiovascular prevention is well understood; however, the role in primary prevention is less clear, and requires careful balancing of potential benefits with risks. Here, we summarize the evidence base on the benefits and risks of aspirin therapy, discuss clinical practice guidelines and decision support tools to assist in initiating aspirin therapy, and highlight ongoing trials that may clarify the role of aspirin in cardiovascular disease prevention. In 2016, the USPSTF released guidelines on the use of aspirin for primary prevention. Based on 11 trials (n = 118,445), aspirin significantly reduced all-cause mortality and nonfatal myocardial infarction, and in 7 trials that evaluated aspirin ≤ 100 mg/day, there was significant reduction in nonfatal stroke. The USPSTF recommends individualized use of aspirin based on factors including age, 10-year atherosclerotic cardiovascular disease risk score, and bleeding risk. Several ongoing trials are evaluating the role of aspirin in primary prevention, secondary prevention, and in combination therapy for atrial fibrillation. Evidence-based approaches to aspirin use should consider the anti-ischemic benefits and bleeding risks from aspirin. In this era of precision medicine, tools that provide the personalized benefit to risk assessment, such as the freely available clinical decision support tool (Aspirin-Guide), can be easily incorporated into the electronic health record and facilitate more informed decisions about initiating aspirin therapy for primary prevention. Aspirin has a complex matrix of benefits and risks, and its use in primary prevention requires individualized decision-making. Results from ongoing trials may guide healthcare providers in identifying appropriate candidates for aspirin therapy.

Monitoring Coastal Marshes for Persistent Saltwater Intrusion

NASA Technical Reports Server (NTRS)

Kalcic, Maria; Hall, Callie; Fletcher, Rose; Russell, Jeff

2009-01-01

Primary goal: Provide resource managers with remote sensing products that support ecosystem forecasting models requiring salinity and inundation data. Work supports the habitat-switching modules in the Coastal Louisiana Ecosystem Assessment and Restoration (CLEAR) model, which provides scientific evaluation for restoration management (Visser et al., 2008). Ongoing work to validate flooding with radar (NWRC/USGS) and enhance persistence estimates through "fusion" of MODIS and Landsat time series (ROSES A.28 Gulf of Mexico). Additional work will also investigate relationship between saltwater dielectric constant and radar returns (Radarsat) (ROSES A.28 Gulf of Mexico).

Solid Waste Management Requirements Definition for Advanced Life Support Missions: Results

NASA Technical Reports Server (NTRS)

Alazraki, Michael P.; Hogan, John; Levri, Julie; Fisher, John; Drysdale, Alan

2002-01-01

Prior to determining what Solid Waste Management (SWM) technologies should be researched and developed by the Advanced Life Support (ALS) Project for future missions, there is a need to define SWM requirements. Because future waste streams will be highly mission-dependent, missions need to be defined prior to developing SWM requirements. The SWM Working Group has used the mission architecture outlined in the System Integration, Modeling and Analysis (SIMA) Element Reference Missions Document (RMD) as a starting point in the requirement development process. The missions examined include the International Space Station (ISS), a Mars Dual Lander mission, and a Mars Base. The SWM Element has also identified common SWM functionalities needed for future missions. These functionalities include: acceptance, transport, processing, storage, monitoring and control, and disposal. Requirements in each of these six areas are currently being developed for the selected missions. This paper reviews the results of this ongoing effort and identifies mission-dependent resource recovery requirements.

New Direction of NASA Exploration Life Support

NASA Technical Reports Server (NTRS)

Chambliss, Joe; Lawson, B. Michael; Barta, Daniel J.

2006-01-01

NASA's activities in life support Research and Technology Development (R&TD) have changed in both focus and scope following implementation of recommendations from the Exploration System Architecture Study (ESAS). The limited resources available and the compressed schedule to conduct life support R&TD have required that future efforts address the needs of the Crew Exploration Vehicle (CEV), the Lunar Surface Access Module (LSAM) and Lunar Outpost (LO). Advanced Life Support (ALS) efforts related to long duration planetary bases have been deferred or canceled. This paper describes the scope of the new Exploration Life Support (ELS) project; how it differs from ALS, and how it supports critical needs for the CEV, LSAM and LO. In addition, this paper provides rationale for changes in the scope and focus of technical content within ongoing life support R&TD activities.

The Columbus logistics support at the APMC: Requirements and implementation aspects

NASA Technical Reports Server (NTRS)

Canu, C.; Battocchio, L.; Masullo, S.

1993-01-01

This paper focuses on the logistics support to be provided by the APM Center (APMC). Among the Columbus ground infrastructures, this center is tasked to provide logistics, sustaining engineering and P/L integration support to the ongoing missions of the APM, i.e. the Columbus Laboratory attached to the Freedom Space Station. The following is illustrated: an analysis of the requirements that are levied on the logistics support of the APM; how such requirements are reflected in the corresponding support to be available on-ground and at APMC; the functional components of the APMC logistics support and how such components interact each other; how the logistics support function interfaces with the other functions of the ground support; and how the logistics support is being designed in terms of resources (such as hardware, data bases, etc.). Emphasis is given to the data handling aspects and to the related data bases that will constitute for the logistics activities the fundamental source of information during the APM planned lifetime. Functional and physical architectures, together with trades for possible implementation, are addressed. Commonalities with other centers are taken into account and recommendations are made for possible reuse of tools already developed in the C/D phase. Finally, programmatic considerations are discussed for the actual implementation of the center.

A Needs Assessment to Identify the Reality of Two Rural School Cases in South Africa: Potential for ICT4D or Not?

ERIC Educational Resources Information Center

Pade-Khene, C.

2012-01-01

Understanding the potential or need for ICT support in education within developing countries, requires an in-depth needs assessment to comprehend, elaborate and set the desired priorities of rural schools. A Needs Assessment was conducted as part of an on-going comprehensive evaluation process of an ICT for development project, the Siyakhula…

An Application of Double-Loop Learning to Community College Remedial Education: A New Model of Integrated Supports for Ongoing Student Success

ERIC Educational Resources Information Center

Doren, Andrew T.

2013-01-01

Community colleges have multiple missions and one of them is to provide open access services to those seeking to further their education. Community colleges provide remedial courses in math, reading, and writing because many of their students do not meet entrance requirements in these core subjects. However, the usual developmental education track…

ORAC: a modern observing system for UKIRT

NASA Astrophysics Data System (ADS)

Bridger, Alan; Wright, Gillian S.; Economou, Frossie; Tan, Min; Currie, Malcolm J.; Pickup, David A.; Adamson, Andrew J.; Rees, Nicholas P.; Purves, Maren; Kackley, Russell

2000-06-01

The steady improvement in telescope performance at UKIRT and the increase in data acquisition rates led to a strong desired for an integrated observing framework that would meet the needs of future instrumentation, as well as providing some support for existing instrumentation. Thus the Observatory Reduction and Acquisition Control (ORAC) project was created in 1997 with the goals of improving the scientific productivity in the telescope, reducing the overall ongoing support requirements, and eventually supporting the use of more flexibly scheduled observing. The project was also expected to achieve this within a tight resource allocation. In October 1999 the ORAC system was commissioned at the United Kingdom Infrared Telescope.

Extended Operation of Stirling Convertors at NASA Glenn Research Center

NASA Technical Reports Server (NTRS)

Oriti, Salvatore

2011-01-01

Glenn Research Center (GRC) is supporting life and reliability database for free-piston Stirilng conversion via extended convertor operation Ongoing convertor operation: 18 convertors (4 TDCs from Infinia, 14 ASCs from Sunpower). 350,000 total convertor hours of operation. 218,000 on Infinia units and 132,000 on Sunpower units. Demonstrating steady convertor performance requires precise maintenance of operating conditions. Sources of disruption : Investigative tests: Varying operating frequency, hot-end temp, cold-end temp. Hot end control method: Constant heat input mode requires more user-adjustment than constant temperature mode. Long-term transients in hot end insulation were observed. Support facility: Open-bath circulator fluid concentration drifting. Nuisance shutdowns (instrumentation failure, EMI, power outages). Ambient temperature fluctuations due to room HVAC.

Work environment stressors, social support, anxiety, and depression among secondary school teachers.

PubMed

Mahan, Pamela L; Mahan, Michael P; Park, Na-Jin; Shelton, Christie; Brown, Kathleen C; Weaver, Michael T

2010-05-01

Work environment stress, a salient health and safety issue for secondary school teachers, school administrators, parents, and students, was examined in 168 teachers from two urban and five suburban high schools. The purpose of this study was to examine relationships between ongoing and episodic stressors and anxiety and depression, as well as the extent to which anxiety and depression may be predicted by stressors and coworker and supervisor support. The Ongoing Stressor Scale (OSS) and the Episodic Stressor Scale (ESS), the Coworker and Supervisor Contents of Communication Scales (COCS), the State Anxiety inventory (S-Anxiety), and the Center for Epidemiological Studies Depression Scale (CES-D) were used to measure the variables. Ongoing and episodic stressors were significantly and positively associated with anxiety and depression. Ongoing stressors and coworker support were significant in explaining anxiety and depression among secondary school teachers. Coworker support had an inverse relationship to anxiety and depression.

Volunteer involvement in the support of self-managed computerised aphasia treatment: The volunteer perspective.

PubMed

Palmer, Rebecca; Enderby, Pam

2016-10-01

The speech-language pathology profession has explored a number of approaches to support efficient delivery of interventions for people with stroke-induced aphasia. This study aimed to explore the role of volunteers in supporting self-managed practice of computerised language exercises. A qualitative interview study of the volunteer support role was carried out alongside a pilot randomised controlled trial of computer aphasia therapy. Patients with aphasia practised computer exercises tailored for them by a speech-language pathologist at home regularly for 5 months. Eight of the volunteers who supported the intervention took part in semi-structured interviews. Interviews were audio recorded, transcribed verbatim and analysed thematically. Emergent themes included: training and support requirements; perception of the volunteer role; challenges facing the volunteer, in general and specifically related to supporting computer therapy exercises. The authors concluded that volunteers helped to motivate patients to practise their computer therapy exercises and also provided support to the carers. Training and ongoing structured support of therapy activity and conduct is required from a trained speech-language pathologist to ensure the successful involvement of volunteers supporting impairment-based computer exercises in patients' own homes.

Department of Energy Natural Phenomena Hazards Mitigation Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Murray, R.C.

1993-09-01

This paper will present a summary of past and present accomplishments of the Natural Phenomena Hazards Program that has been ongoing at Lawrence Livermore National Laboratory since 1975. The Natural Phenomena covered includes earthquake; winds, hurricanes, and tornadoes; flooding and precipitation; lightning; and volcanic events. The work is organized into four major areas (1) Policy, requirements, standards, and guidance (2) Technical support, research development, (3) Technology transfer, and (4) Oversight.

Calibration of the head direction network: a role for symmetric angular head velocity cells.

PubMed

Stratton, Peter; Wyeth, Gordon; Wiles, Janet

2010-06-01

Continuous attractor networks require calibration. Computational models of the head direction (HD) system of the rat usually assume that the connections that maintain HD neuron activity are pre-wired and static. Ongoing activity in these models relies on precise continuous attractor dynamics. It is currently unknown how such connections could be so precisely wired, and how accurate calibration is maintained in the face of ongoing noise and perturbation. Our adaptive attractor model of the HD system that uses symmetric angular head velocity (AHV) cells as a training signal shows that the HD system can learn to support stable firing patterns from poorly-performing, unstable starting conditions. The proposed calibration mechanism suggests a requirement for symmetric AHV cells, the existence of which has previously been unexplained, and predicts that symmetric and asymmetric AHV cells should be distinctly different (in morphology, synaptic targets and/or methods of action on postsynaptic HD cells) due to their distinctly different functions.

Developing learning environments which support early algebraic reasoning: a case from a New Zealand primary classroom

NASA Astrophysics Data System (ADS)

Hunter, Jodie

2014-12-01

Current reforms in mathematics education advocate the development of mathematical learning communities in which students have opportunities to engage in mathematical discourse and classroom practices which underlie algebraic reasoning. This article specifically addresses the pedagogical actions teachers take which structure student engagement in dialogical discourse and activity which facilitates early algebraic reasoning. Using videotaped recordings of classroom observations, the teacher and researcher collaboratively examined the classroom practices and modified the participatory practices to develop a learning environment which supported early algebraic reasoning. Facilitating change in the classroom environment was a lengthy process which required consistent and ongoing attention initially to the social norms and then to the socio-mathematical norms. Specific pedagogical actions such as the use of specifically designed tasks, materials and representations and a constant press for justification and generalisation were required to support students to link their numerical understandings to algebraic reasoning.

Online Teaching Efficacy: A Product of Professional Development and Ongoing Support.

PubMed

Richter, Sally; Idleman, Lynda

2017-08-22

The purpose of the pilot study was to investigate the perceptions of online teaching efficacy of nursing faculty who teach courses in which 51% or more of the content is offered online. Bandura's psychological construct of self-efficacy served as the conceptual framework. The research survey was administered to nursing faculty in a state university system located in the southeastern United States of America, plus two private universities. The Michigan Nurse Educator's Sense of Efficacy for Online Teaching Scale, which contains 32 items that measure how nurse educators judge their current capabilities for teaching online nursing courses, was used to gather data. Overall, the scores reflected that faculty perceived themselves as quite a bit efficacious on a scale that ranged from 1 to 9. As nursing educators received more support in designing and implementing online courses, their efficacy increased. It is critical that faculty are supported on an ongoing basis to increase and develop online teaching skills in order to teach high-quality courses in online programs. Faculty members must also be recognized for their work, time, and commitment required to be effective online educators. The findings of this study revealed those participants who had a number of professional development supports and release time to develop online courses have a greater sense of efficacy.

New EVSE Analytical Tools/Models: Electric Vehicle Infrastructure Projection Tool (EVI-Pro)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wood, Eric W; Rames, Clement L; Muratori, Matteo

This presentation addresses the fundamental question of how much charging infrastructure is needed in the United States to support PEVs. It complements ongoing EVSE initiatives by providing a comprehensive analysis of national PEV charging infrastructure requirements. The result is a quantitative estimate for a U.S. network of non-residential (public and workplace) EVSE that would be needed to support broader PEV adoption. The analysis provides guidance to public and private stakeholders who are seeking to provide nationwide charging coverage, improve the EVSE business case by maximizing station utilization, and promote effective use of private/public infrastructure investments.

Communication Simulations for Power System Applications

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fuller, Jason C.; Ciraci, Selim; Daily, Jeffrey A.

2013-05-29

New smart grid technologies and concepts, such as dynamic pricing, demand response, dynamic state estimation, and wide area monitoring, protection, and control, are expected to require considerable communication resources. As the cost of retrofit can be high, future power grids will require the integration of high-speed, secure connections with legacy communication systems, while still providing adequate system control and security. While considerable work has been performed to create co-simulators for the power domain with load models and market operations, limited work has been performed in integrating communications directly into a power domain solver. The simulation of communication and power systemsmore » will become more important as the two systems become more inter-related. This paper will discuss ongoing work at Pacific Northwest National Laboratory to create a flexible, high-speed power and communication system co-simulator for smart grid applications. The framework for the software will be described, including architecture considerations for modular, high performance computing and large-scale scalability (serialization, load balancing, partitioning, cross-platform support, etc.). The current simulator supports the ns-3 (telecommunications) and GridLAB-D (distribution systems) simulators. Ongoing and future work will be described, including planned future expansions for a traditional transmission solver. A test case using the co-simulator, utilizing a transactive demand response system created for the Olympic Peninsula and AEP gridSMART demonstrations, requiring two-way communication between distributed and centralized market devices, will be used to demonstrate the value and intended purpose of the co-simulation environment.« less

Supporting the Thesis Writing Process of International Research Students through an Ongoing Writing Group

ERIC Educational Resources Information Center

Li, Linda Y.; Vandermensbrugghe, Joelle

2011-01-01

Evidence from research suggests writing support is particularly needed for international research students who have to tackle the challenges of thesis writing in English as their second language in Western academic settings. This article reports the development of an ongoing writing group to support the thesis writing process of international…

Development and Testing of Carbon-Carbon Nozzle Extensions for Upper Stage Liquid Rocket Engines

NASA Technical Reports Server (NTRS)

Valentine, Peter G.; Gradl, Paul R.; Greene, Sandra E.

2017-01-01

Carbon-carbon (C-C) composite nozzle extensions are of interest for use on a variety of launch vehicle upper stage engines and in-space propulsion systems. The C-C nozzle extension technology and test capabilities being developed are intended to support National Aeronautics and Space Administration (NASA) and Department of Defense (DOD) requirements, as well as those of the broader Commercial Space industry. For NASA, C-C nozzle extension technology development primarily supports the NASA Space Launch System (SLS) and NASA's Commercial Space partners. Marshall Space Flight Center (MSFC) efforts are aimed at both (a) further developing the technology and databases needed to enable the use of composite nozzle extensions on cryogenic upper stage engines, and (b) developing and demonstrating low-cost capabilities for testing and qualifying composite nozzle extensions. Recent, on-going, and potential future work supporting NASA, DOD, and Commercial Space needs will be discussed. Information to be presented will include (a) recent and on-going mechanical, thermal, and hot-fire testing, as well as (b) potential future efforts to further develop and qualify domestic C-C nozzle extension solutions for the various upper stage engines under development.

The Use of the Data-to-Action Framework in the Evaluation of CDC's DELTA FOCUS Program.

PubMed

Armstead, Theresa L; Kearns, Megan; Rambo, Kirsten; Estefan, Lianne Fuino; Dills, Jenny; Rivera, Moira S; El-Beshti, Rasha

The Centers for Disease Control and Prevention's (CDC's) Domestic Violence Prevention Enhancements and Leadership Through Alliances, Focusing on Outcomes for Communities United with States (DELTA FOCUS) program is a 5-year cooperative agreement (2013-2018) funding 10 state domestic violence coalitions and local coordinated community response teams to engage in primary prevention of intimate partner violence. Grantees' prevention strategies were often developmental and emergent; therefore, CDC's approach to program oversight, administration, and support to grantees required a flexible approach. CDC staff adopted a Data-to-Action Framework for the DELTA FOCUS program evaluation that supported a culture of learning to meet dynamic and unexpected information needs. Briefly, a Data-to-Action Framework involves the collection and use of information in real time for program improvement. Utilizing this framework, the DELTA FOCUS data-to-action process yielded important insights into CDC's ongoing technical assistance, improved program accountability by providing useful materials, and information for internal agency leadership, and helped build a learning community among grantees. CDC and other funders, as decision makers, can promote program improvements that are data-informed by incorporating internal processes supportive of ongoing data collection and review.

Research and development of optical measurement techniques for aerospace propulsion research: A NASA Lewis Research Center perspective

NASA Technical Reports Server (NTRS)

Lesco, Daniel J.

1991-01-01

The applied research effort required to develop new nonintrusive measurement techniques capable of obtaining the data required by aerospace propulsion researchers and of operating in the harsh environments encountered in research and test facilities is discussed and illustrated through several ongoing projects at NASA's Lewis Research Center. Factors including length of development time, funding levels, and collaborative support from fluid-thermal researchers are cited. Progress in developing new instrumentation via a multi-path approach, including NASA research, grant, and government-sponsored research through mechanisms like the Small Business Innovative Research program, is also described.

Real-time operating system for selected Intel processors

NASA Technical Reports Server (NTRS)

Pool, W. R.

1980-01-01

The rationale for system development is given along with reasons for not using vendor supplied operating systems. Although many system design and performance goals were dictated by problems with vendor supplied systems, other goals surfaced as a result of a design for a custom system able to span multiple projects. System development and management problems and areas that required redesign or major code changes for system implementation are examined as well as the relative successes of the initial projects. A generic description of the actual project is provided and the ongoing support requirements and future plans are discussed.

Evolving career choice narratives of new graduate nurses.

PubMed

Price, Sheri L; McGillis Hall, Linda; Murphy, Gail Tomblin; Pierce, Bridget

2018-01-01

This article describes findings from one stage of a longitudinal study of the professional socialization experiences of Millennial nurses as they prepared for graduation and transition to practice. This study employed an interpretive narrative methodology guided by Polkinghorne's theory of narrative identity. Analysis of face-to-face interviews and journal entries by Millennial nursing students uncovered the formal professional socialization experiences over four years of nursing education. Participants include six Millennial nursing student participants (born after 1980) interviewed approximately one-month aftergraduation. These six participants are a voluntary subset of twelve who were interviewed prior to beginning their nursing studies, the analysis of which is captured in Price et al. (2013a) and Price et al. (2013b). Narrative analysis of the post-graduation interviews resulted in three main themes: 'Real Nursing: Making a Difference', 'The Good Nurse: Defined by Practice' and 'Creating Career Life Balance'. Graduate nurses strive to provide excellent nursing care as they transition into the workforce and identify a need for ongoing peer and professional supports to assist their ongoing professional socialization. Ongoing formal socialization and professional development is required to support the transition and retention of new nurse graduates in the workplace and the profession. Millenial generation nurses seek opportunities for career mapping, goal setting and formal mentorship by role models and peers to actualize their professional aspirations. Copyright © 2017. Published by Elsevier Ltd.

Peer support for people with chronic conditions in rural areas: a scoping review.

PubMed

Lauckner, Heidi M; Hutchinson, Susan L

2016-01-01

Chronic conditions are a growing healthcare concern. People living in rural regions are particularly affected because many barriers exist to accessing services and supports. Peer support for chronic condition self-management, where people living with chronic conditions learn about how to care for themselves and maintain their health from people also living with chronic conditions, is one approach gaining recognition. What remains unknown are the unique challenges and strategies associated with peer support for chronic condition self-management in rural contexts. In order to inform the development of peer supports in the authors' local context in rural eastern Canada, a scoping review was undertaken to discover community-based peer support initiatives for adults in rural settings living with chronic conditions. The authors followed established scoping review methods to answer the research question What is known from the existing literature about the key features and potential formats of community-based peer support initiatives for adults living with chronic conditions in rural settings? Six databases (CINAHL, PubMed, Sociological Abstracts, Embase, Cochrane Libraries and PsycInfo) were searched using the following concepts: chronic conditions, peer support, community-based and rural context. Two researchers reviewed the titles and/or abstracts of the 1978 articles retrieved from the initial search to include articles that were in English, published in 2000 to 2014, and that explicitly discussed rural programs/interventions with peers that were community-based. The initial screen excluded 1907 articles, leaving 71 articles, which were read by two research members in light of the inclusion/exclusion criteria. Thirteen articles representing 10 separate programs were included and analyzed using qualitative content analysis. Included programs were from the USA, Australia and Canada. A range of formats (telecommunications only, in-person meetings only, or a combination of both) were used. Peer leaders had varied experiences with chronic conditions and received training in content and facilitation skills. Peer leaders were provided with ongoing support. Program participants received training on chronic conditions, and programs provided opportunities for social support and the development of new skills. Programs focused on creating social connections, reducing stigma, ensuring relevance and promoting empowerment. Of the nine programs that reported outcomes, eight reported positive outcomes and one reported mixed results. Consistent with the extant literature, the programs identified unique issues faced by people with chronic conditions in rural areas that these programs addressed. The key findings of this scoping review are as follows: 1. A combination of telecommunications with some face-to-face meetings can support the accessibility of peer support programs in rural areas. 2. Core elements of these programs are the provision of social support and skill development. 3. Peer leaders benefit from skills training and ongoing support. 4. Sustainability of such programs is complex and requires multiple strategies. Cultural relevance, ongoing support and the use of telecommunications were key features of rural peer support programs. Guiding questions to facilitate a community consultation around these findings are provided. Peer support chronic condition self-management programs require further research.

Aviation Weather Information Communications Study (AWIN). Phase 1 and 2

NASA Technical Reports Server (NTRS)

Ball, J. W.; Herron, R. G.; Nozawa, E. T.; Thomas, E. A.; Witchey, R. D.

2000-01-01

This two part study examines the communication requirements to provide weather information in the cockpit as well as public and private communication systems available to address the requirements. Ongoing research projects combined with user needs for weather related information are used to identify and describe potential weather products that address decision support in three time frames: Far-Term Strategic, Near-Term Strategic and Tactical. Data requirements of these future products are identified and quantified. Communications systems and technologies available in the public as well as private sector are analyzed to identify potential solutions. Recommendations for further research identify cost, performance, and safety benefits to justify the investment. The study concludes that not all weather information has the same level of urgency to safety-of-flight and some information is more critical to one category of flight than another. Specific weather products need to be matched with communication systems with appropriate levels of reliability to support the criticality of the information. Available bandwidth for highly critical information should be preserved and dedicated to safety. Meanwhile, systems designed for in-flight-entertainment and other passenger/crew services could be used to support less critical information that is used only for planning and economic decision support.

Building capacity for antiretroviral delivery in South Africa: A qualitative evaluation of the PALSA PLUS nurse training programme

PubMed Central

Stein, J; Lewin, S; Fairall, L; Mayers, P; English, R; Bheekie, A; Bateman, E; Zwarenstein, M

2008-01-01

Background South Africa recently launched a national antiretroviral treatment programme. This has created an urgent need for nurse-training in antiretroviral treatment (ART) delivery. The PALSA PLUS programme provides guidelines and training for primary health care (PHC) nurses in the management of adult lung diseases and HIV/AIDS, including ART. A process evaluation was undertaken to document the training, explore perceptions regarding the value of the training, and compare the PALSA PLUS training approach (used at intervention sites) with the provincial training model. The evaluation was conducted alongside a randomized controlled trial measuring the effects of the PALSA PLUS nurse-training (Trial reference number ISRCTN24820584). Methods Qualitative methods were utilized, including participant observation of training sessions, focus group discussions and interviews. Data were analyzed thematically. Results Nurse uptake of PALSA PLUS training, with regard not only to ART specific components but also lung health, was high. The ongoing on-site training of all PHC nurses, as opposed to the once-off centralized training provided for ART nurses only at non-intervention clinics, enhanced nurses' experience of support for their work by allowing, not only for ongoing experiential learning, supervision and emotional support, but also for the ongoing managerial review of all those infrastructural and system-level changes required to facilitate health provider behaviour change and guideline implementation. The training of all PHC nurses in PALSA PLUS guideline use, as opposed to ART nurses only, was also perceived to better facilitate the integration of AIDS care within the clinic context. Conclusion PALSA PLUS training successfully engaged all PHC nurses in a comprehensive approach to a range of illnesses affecting both HIV positive and negative patients. PHC nurse-training for integrated systems-based interventions should be prioritized on the ART funding agenda. Training for individual provider behaviour change is nonetheless only one aspect of the ongoing system-wide interventions required to effect lasting improvements in patient care in the context of an over-burdened and under-resourced PHC system. PMID:19017394

7 CFR 25.403. - Ongoing 2-year work plan requirement.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 25.403. Agriculture Office of the Secretary of Agriculture RURAL EMPOWERMENT ZONES AND ENTERPRISE COMMUNITIES Post-Designation Requirements § 25.403. Ongoing 2-year work plan requirement. (a) Each Empowerment... conditional upon the designation of the community as an Empowerment Zone; and (iv) Documentation of...

7 CFR 25.403. - Ongoing 2-year work plan requirement.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 25.403. Agriculture Office of the Secretary of Agriculture RURAL EMPOWERMENT ZONES AND ENTERPRISE COMMUNITIES Post-Designation Requirements § 25.403. Ongoing 2-year work plan requirement. (a) Each Empowerment... conditional upon the designation of the community as an Empowerment Zone; and (iv) Documentation of...

7 CFR 25.403. - Ongoing 2-year work plan requirement.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 25.403. Agriculture Office of the Secretary of Agriculture RURAL EMPOWERMENT ZONES AND ENTERPRISE COMMUNITIES Post-Designation Requirements § 25.403. Ongoing 2-year work plan requirement. (a) Each Empowerment... conditional upon the designation of the community as an Empowerment Zone; and (iv) Documentation of...

7 CFR 25.403. - Ongoing 2-year work plan requirement.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 25.403. Agriculture Office of the Secretary of Agriculture RURAL EMPOWERMENT ZONES AND ENTERPRISE COMMUNITIES Post-Designation Requirements § 25.403. Ongoing 2-year work plan requirement. (a) Each Empowerment... conditional upon the designation of the community as an Empowerment Zone; and (iv) Documentation of...

Informal Assessment as a Tool for Supporting Parent Partnerships

ERIC Educational Resources Information Center

Darragh, Johnna

2009-01-01

Many strategies contribute to forming co-constructed relationships. However, one of the most effective tools that supports co-construction is ongoing assessment, which provides a common base (knowledge of the child) on which families and professionals can build relationships. As a part of this ongoing assessment, informal strategies--including…

The cost of sustaining a patient-centered medical home: experience from 2 states.

PubMed

Magill, Michael K; Ehrenberger, David; Scammon, Debra L; Day, Julie; Allen, Tatiana; Reall, Andreu J; Sides, Rhonda W; Kim, Jaewhan

2015-09-01

As medical practices transform to patient-centered medical homes (PCMHs), it is important to identify the ongoing costs of maintaining these "advanced primary care" functions. A key required input is personnel effort. This study's objective was to assess direct personnel costs to practices associated with the staffing necessary to deliver PCMH functions as outlined in the National Committee for Quality Assurance Standards. We developed a PCMH cost dimensions tool to assess costs associated with activities uniquely required to maintain PCMH functions. We interviewed practice managers, nurse supervisors, and medical directors in 20 varied primary care practices in 2 states, guided by the tool. Outcome measures included categories of staff used to perform various PCMH functions, time and personnel costs, and whether practices were delivering PCMH functions. Costs per full-time equivalent primary care clinician associated with PCMH functions varied across practices with an average of $7,691 per month in Utah practices and $9,658 in Colorado practices. PCMH incremental costs per encounter were $32.71 in Utah and $36.68 in Colorado. The average estimated cost per member per month for an assumed panel of 2,000 patients was $3.85 in Utah and $4.83 in Colorado. Identifying costs of maintaining PCMH functions will contribute to effective payment reform and to sustainability of transformation. Maintenance and ongoing support of PCMH functions require additional time and new skills, which may be provided by existing staff, additional staff, or both. Adequate compensation for ongoing and substantial incremental costs is critical for practices to sustain PCMH functions. © 2015 Annals of Family Medicine, Inc.

The Cost of Sustaining a Patient-Centered Medical Home: Experience From 2 States

PubMed Central

Magill, Michael K.; Ehrenberger, David; Scammon, Debra L.; Day, Julie; Allen, Tatiana; Reall, Andreu J.; Sides, Rhonda W.; Kim, Jaewhan

2015-01-01

PURPOSE As medical practices transform to patient-centered medical homes (PCMHs), it is important to identify the ongoing costs of maintaining these “advanced primary care” functions. A key required input is personnel effort. This study’s objective was to assess direct personnel costs to practices associated with the staffing necessary to deliver PCMH functions as outlined in the National Committee for Quality Assurance Standards. METHODS We developed a PCMH cost dimensions tool to assess costs associated with activities uniquely required to maintain PCMH functions. We interviewed practice managers, nurse supervisors, and medical directors in 20 varied primary care practices in 2 states, guided by the tool. Outcome measures included categories of staff used to perform various PCMH functions, time and personnel costs, and whether practices were delivering PCMH functions. RESULTS Costs per full-time equivalent primary care clinician associated with PCMH functions varied across practices with an average of $7,691 per month in Utah practices and $9,658 in Colorado practices. PCMH incremental costs per encounter were $32.71 in Utah and $36.68 in Colorado. The average estimated cost per member per month for an assumed panel of 2,000 patients was $3.85 in Utah and $4.83 in Colorado. CONCLUSIONS Identifying costs of maintaining PCMH functions will contribute to effective payment reform and to sustainability of transformation. Maintenance and ongoing support of PCMH functions require additional time and new skills, which may be provided by existing staff, additional staff, or both. Adequate compensation for ongoing and substantial incremental costs is critical for practices to sustain PCMH functions. PMID:26371263

Ask nicely. Healthcare organizations looking for grant money must appreciate the art and science behind the process.

PubMed

Raths, David

2009-01-01

Focus the grant application on addressing content areas, such as chronic disease management, that have an essential IT component, rather than on the technology itself. Community partnerships are much more likely to win grant funding than individual organizations. Take the time to understand the goals, interests and requirements of the funding agencies. Each has its own expectations about measurable results and about ongoing support after grant funding runs out.

ESA Technologies for Space Debris Remediation

NASA Astrophysics Data System (ADS)

Wormnes, K.; Le Letty, R.; Summerer, L.; Schonenborg, R.; Dubois-Matra, O.; Luraschi, E.; Cropp, A.; Krag, H.; Delaval, J.

2013-08-01

Space debris is an existing and growing problem for space operations. Studies show that for a continued use of LEO, 5 - 10 large and strategically chosen debris need to be removed every year. The European Space Agency (ESA) is actively pursuing technologies and systems for space debris removal under its Clean Space initiative. This overview paper describes the activities that are currently ongoing at ESA and that have already been completed. Additionally it outlines the plan for the near future. The technologies under study fall in two main categories corresponding to whether a pushing or a pulling manoeuvre is required for the de-orbitation. ESA is studying the option of using a tethered capture system for controlled de-orbitation through pulling where the capture is performed using throw-nets or alternatively a harpoon. The Agency is also studying rigid capture systems with a particular emphasis on tentacles (potentially combined with a robotic arm). Here the de-orbitation is achieved through a push-manoeuvre. Additionally, a number of activities will be discussed that are ongoing to develop supporting technologies for these scenarios, or to develop systems for de-orbiting debris that can be allowed to re-enter in an uncontrolled manner. The short term goal and main driver for the current technology developments is to achieve sufficient TRL on required technologies to support a potential de-orbitation mission to remove a large and strategically chosen piece of debris.

The Need for Vendor Source Code at NAS. Revised

NASA Technical Reports Server (NTRS)

Carter, Russell; Acheson, Steve; Blaylock, Bruce; Brock, David; Cardo, Nick; Ciotti, Bob; Poston, Alan; Wong, Parkson; Chancellor, Marisa K. (Technical Monitor)

1997-01-01

The Numerical Aerodynamic Simulation (NAS) Facility has a long standing practice of maintaining buildable source code for installed hardware. There are two reasons for this: NAS's designated pathfinding role, and the need to maintain a smoothly running operational capacity given the widely diversified nature of the vendor installations. NAS has a need to maintain support capabilities when vendors are not able; diagnose and remedy hardware or software problems where applicable; and to support ongoing system software development activities whether or not the relevant vendors feel support is justified. This note provides an informal history of these activities at NAS, and brings together the general principles that drive the requirement that systems integrated into the NAS environment run binaries built from source code, onsite.

Modular Software for Spacecraft Navigation Using the Global Positioning System (GPS)

NASA Technical Reports Server (NTRS)

Truong, S. H.; Hartman, K. R.; Weidow, D. A.; Berry, D. L.; Oza, D. H.; Long, A. C.; Joyce, E.; Steger, W. L.

1996-01-01

The Goddard Space Flight Center Flight Dynamics and Mission Operations Divisions have jointly investigated the feasibility of engineering modular Global Positioning SYSTEM (GPS) navigation software to support both real time flight and ground postprocessing configurations. The goals of this effort are to define standard GPS data interfaces and to engineer standard, reusable navigation software components that can be used to build a broad range of GPS navigation support applications. The paper discusses the GPS modular software (GMOD) system and operations concepts, major requirements, candidate software architecture, feasibility assessment and recommended software interface standards. In additon, ongoing efforts to broaden the scope of the initial study and to develop modular software to support autonomous navigation using GPS are addressed,

77 FR 73586 - Further Inquiry Into Issues Related to Mobility Fund Phase II

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-11

... certain issues relating to the award of ongoing support for advanced mobile services. DATES: Comments are... availability of mobile broadband and high quality voice services in certain areas. Building on the comments... comprehensive record on certain issues related to the award of ongoing support for advanced mobile services. In...

Initial and Ongoing Teacher Preparation and Support: Current Problems and Possible Solutions

ERIC Educational Resources Information Center

Johnson, Harold A.

2013-01-01

The effective initial preparation and ongoing support of teachers of students who are deaf and hard of hearing has always been a difficult and controversial task. Changes in student demographic characteristics and educational settings, combined with the rapidly diminishing number and diversity of deaf education teacher preparation (DETP) programs,…

Evaluation of an ongoing psychoeducational inflammatory bowel disease support group in an adult outpatient setting.

PubMed

McMaster, Kristin; Aguinaldo, Laika; Parekh, Nimisha K

2012-01-01

Previous studies assessing efficacy of support groups for patients with inflammatory bowel disease showed mixed results in terms of attendance and overall effectiveness. In this study, researchers evaluated the use of an ongoing open psychoeducational support group for adult patients with inflammatory bowel disease in an outpatient tertiary setting. The sample consisted of 18 adults who have attended more than 2 meetings of the support group. Topics addressed in the support group include complementary medicine, diet and nutrition, the psychological impact of inflammatory bowel disease, medication and side effects, and insurance/disability. Participants were asked to complete the Client Satisfaction Questionnaire, Multidimensional Support Scale, 11 general demographic questions, and a brief open-ended qualitative questionnaire developed by the researchers. Results demonstrated that participants reported very high satisfaction with the support group and rated the adequacy of peer support from others with inflammatory bowel disease higher than support from family/friends and professionals. A majority of group members reported joining the group for mutual support and education; this expectation was met through the psychoeducational structure of the group. This study demonstrates the potential for success of an ongoing psychoeducational inflammatory bowel disease support group for adult patients and their caregivers.

ICESat-2 laser technology development

NASA Astrophysics Data System (ADS)

Edwards, Ryan; Sawruk, Nick W.; Hovis, Floyd E.; Burns, Patrick; Wysocki, Theodore; Rudd, Joe; Walters, Brooke; Fakhoury, Elias; Prisciandaro, Vincent

2013-09-01

A number of ICESat-2 system requirements drove the technology evolution and the system architecture for the laser transmitter Fibertek has developed for the mission.. These requirements include the laser wall plug efficiency, laser reliability, high PRF (10kHz), short-pulse (<1.5ns), relatively narrow spectral line-width, and wave length tunability. In response to these requirements Fibertek developed a frequency-doubled, master oscillator/power amplifier (MOPA) laser that incorporates direct pumped diode pumped Nd:YVO4 as the gain media, Another guiding force in the system design has been extensive hardware life testing that Fibertek has completed. This ongoing hardware testing and development evolved the system from the original baseline brass board design to the more robust flight laser system. The final design meets or exceeds all NASA requirements and is scalable to support future mission requirements.

Service-based health human resources planning for older adults.

PubMed

Tomblin Murphy, Gail; MacKenzie, Adrian; Rigby, Janet; Rockwood, Kenneth; Gough, Amy; Greeley, Gogi; Montpetit, Frederick; Dill, Donna; Alder, Robert; Lackie, Kelly

2013-08-01

To test a service-based health human resources (HHR) planning approach for older adults in the context of home and long term care (LTC); to create a practical template/tools for use in various jurisdictions and/or health care settings. The most serious health needs of seniors in 2 Canadian jurisdictions were identified and linked to the specific services and associated competencies required of health care providers (HCPs) to address those needs. The amounts of each service required were quantified and compared against the capacity of HCPs to perform the services, measured using a self-assessment survey, by using a previously developed analytical framework. Home and LTC sectors in Nova Scotia and Nunavut, Canada. Regulated and nonregulated HCPs were invited to complete either an online or paper-based competency self-assessment survey. Survey response rates in Nova Scotia and Nunavut were 11% (160 responses) and 20% (22 responses), respectively. Comparisons of the estimated number of seniors likely to need each service with the number who can be served by the workforces in each jurisdiction indicated that the workforces in both jurisdictions are sufficiently numerous, active, productive, and competent to provide most of the services likely to be required. However, significant gaps were identified in pharmacy services, ongoing client assessment, client/family education and involvement, and client/family functional and social supports. Service-based HHR planning is feasible for identifying gaps in services required by older adults, and can guide policy makers in planning hiring/recruitment, professional development, and provider education curricula. Implementation will require commitment of policy makers and other stakeholders, as well as ongoing evaluation of its effectiveness. More broadly, the ongoing effectiveness of the approach will depend on workforce planning being conducted in an iterative way, driven by regular reevaluation of population health needs and HHR effectiveness. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

Reducing chronic obstructive pulmonary disease readmissions: the role of the durable medical equipment provider.

PubMed

Messenger, Robert W

2012-01-01

Exacerbation and frequent rehospitalization in chronic obstructive pulmonary disease exacts a heavy toll on the US health care system. To address these issues, new initiatives have been proposed that are largely based on financial penalties to promote patient education and postdischarge care. However, as laudable as these goals are, improving outcomes in the chronic obstructive pulmonary disease population is more confounding than it may first appear. Chronic hypoxia, cognitive dysfunction, poor nutrition, and economic disadvantage are just a few of the challenges that require creative solutions and ongoing support. Case managers need to utilize all the potential products and services that can assist in improving outcomes for these patients. Durable medical equipment providers are often viewed as purveyors of medical equipment that offer little in the form of clinical support. However, in many cases these providers represent an overlooked resource that provides individualized, highly structured patient education and ongoing support programs. The challenge is in identifying those durable medical equipment providers that offer patients contemporary technology, and have both the resources and the commitment to provide patient support that is amenable to the goals of the hospital. This article reviews many of the confounding issues that contribute to the frequent rehospitalization of chronic obstructive pulmonary disease patients. Recommendations to improve patient education and oxygen therapy outcomes are provided along with suggestions to aid in the vetting of durable medical equipment providers. Acute care hospitals, long-term acute care hospitals, extended care facilities, integrated delivery systems. 1. An understanding of the complex variables that play in the management of chronic obstructive pulmonary disease will help the case manager to plan an effective course of care. 2. Case managers need to ensure that patients receive long-term oxygen technology that supports their lifestyle, promotes compliance, and ultimately achieves the desired outcomes. 3. Case managers must advocate for coordinated, ongoing patient education and stress the need for continuing reinforcement. 4. Case managers must ensure that patients under their care be matched with durable medical equipment providers that provide the technology and support that favors positive clinical outcomes.

Implementing OpenMRS for patient monitoring in an HIV/AIDS care and treatment program in rural Mozambique.

PubMed

Manders, Eric-Jan; José, Eurico; Solis, Manuel; Burlison, Janeen; Nhampossa, José Leopoldo; Moon, Troy

2010-01-01

We have adopted the Open Medical Record System (OpenMRS) framework to implement an electronic patient monitoring system for an HIV care and treatment program in Mozambique. The program provides technical assistance to the Ministry of Health supporting the scale up of integrated HIV care and support services in health facilities in rural resource limited settings. The implementation is in use for adult and pediatric programs, with ongoing roll-out to cover all supported sites. We describe early experiences in adapting the system to the program needs, addressing infrastructure challenges, creating a regional support team, training data entry staff, migrating a legacy database, deployment, and current use. We find that OpenMRS offers excellent prospects for in-country development of health information systems, even in severely resource limited settings. However, it also requires considerable organizational infrastructure investment and technical capacity building to ensure continued local support.

Defining "peerness": Developing peer supports for parents with mental illnesses.

PubMed

Nicholson, Joanne; Valentine, Anne

2018-06-01

This article addresses critical considerations in the development of peer supports for parents with mental illnesses, focusing on the question of what makes a peer a peer in the parent peer specialist domain. The implementation and testing of parent peer supports requires specification of the critical components of the model, including the qualities, characteristics, and unique contributions of the parent peer specialist. Themes emerged in Parent Peer Specialist Project Advisory Group discussions, with members drawing from lived experience, practice expertise, and conversations with experts. In addition to literature review, strategic stakeholder interviews were conducted. Lived experience of mental illness and family life, training, and ongoing support for parent peer specialists, along with key ingredients conveyed by perceived peer-parent similarity, will likely enhance the benefits of peer supports to parents and promote job satisfaction and career advancement for parent peer specialists. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Multichannel demultiplexer/demodulator technologies for future satellite communication systems

NASA Technical Reports Server (NTRS)

Ivancic, William D.; Budinger, James M.; Staples, Edward J.; Abramovitz, Irwin; Courtois, Hector A.

1992-01-01

NASA-Lewis' Space Electronics Div. supports ongoing research in advanced satellite communication architectures, onboard processing, and technology development. Recent studies indicate that meshed VSAT (very small aperture terminal) satellite communication networks using FDMA (frequency division multiple access) uplinks and TDMA (time division multiplexed) downlinks are required to meet future communication needs. One of the critical advancements in such a satellite communication network is the multichannel demultiplexer/demodulator (MCDD). The progress is described which was made in MCDD development using either acousto-optical, optical, or digital technologies.

Software for visualization, analysis, and manipulation of laser scan images

NASA Astrophysics Data System (ADS)

Burnsides, Dennis B.

1997-03-01

The recent introduction of laser surface scanning to scientific applications presents a challenge to computer scientists and engineers. Full utilization of this two- dimensional (2-D) and three-dimensional (3-D) data requires advances in techniques and methods for data processing and visualization. This paper explores the development of software to support the visualization, analysis and manipulation of laser scan images. Specific examples presented are from on-going efforts at the Air Force Computerized Anthropometric Research and Design (CARD) Laboratory.

Service and education share responsibility for nurses' value development.

PubMed

Schank, M J; Weis, D

2001-01-01

This article examines professional values of senior baccalaureate nursing students and practicing nurses. An important finding was that practicing nurses rated behaviors reflecting values in the American Nurses Association (ANA) Code for Nurses as more important than did senior students, thereby supporting the notion that practice contributes to value formation. The ongoing development and internalization of the nursing professions' values requires active involvement by staff development educators. The phenomena of value formation and development of professional values appear to mirror the novice to expert model.

Using SCOR as a Supply Chain Management Framework for Government Agency Contract Requirements

NASA Technical Reports Server (NTRS)

Paxton, Joseph; Tucker, Brian

2010-01-01

This paper will present a model that uses the Supply-Chain Operations Reference (SCOR) model as a foundation for a framework to illustrate the information needed throughout a product lifecycle to support a healthy supply chain management function and the subsequent contract requirements to enable it. It will also show where in the supply chain the information must be extracted. The ongoing case study used to exemplify the model is NASA's (National Aeronautics and Space Administration) Ares I program for human spaceflight. Effective supply chain management and contract requirements are ongoing opportunities for continuous improvement within government agencies, specifically development of systems for human spaceflight operations. Multiple reports from the Government Accountability Office (GAO) reinforce this importance. The SCOR model is a framework for describing a supply chain with process building blocks and business activities. It provides a set of metrics for measuring supply chain performance and best practices for continuously improving. This paper expands the application of the SCOR to also provide the framework for defining information needed from different levels of the supply chain and at different phases of the lifecycle. These needs can be incorporated into contracts to enable more effective supply chain management. Depending on the phase of the lifecycle, effective supply chain management will require involvement from different levels of the organization and different levels of the supply chain.

Can a customer relationship management program improve recruitment for primary care research studies?

PubMed

Johnston, Sharon; Wong, Sabrina T; Blackman, Stephanie; Chau, Leena W; Grool, Anne M; Hogg, William

2017-11-16

Recruiting family physicians into primary care research studies requires researchers to continually manage information coming in, going out, and coming in again. In many research groups, Microsoft Excel and Access are the usual data management tools, but they are very basic and do not support any automation, linking, or reminder systems to manage and integrate recruitment information and processes. We explored whether a commercial customer relationship management (CRM) software program - designed for sales people in businesses to improve customer relations and communications - could be used to make the research recruitment system faster, more effective, and more efficient. We found that while there was potential for long-term studies, it simply did not adapt effectively enough for our shorter study and recruitment budget. The amount of training required to master the software and our need for ongoing flexible and timely support were greater than the benefit of using CRM software for our study.

Critical thinking in nurse managers.

PubMed

Zori, Susan; Morrison, Barbara

2009-01-01

Formal education and support is needed for nurse managers to effectively function in their role in the current health care environment. Many nurse managers assume their positions based on expertise in a clinical role with little expertise in managerial and leadership skills. Operating as a manager and leader requires ongoing development of critical thinking skills and the inclination to use those skills. Critical thinking can have a powerful influence on the decision making and problem solving that nurse managers are faced with on a daily basis. The skills that typify critical thinking include analysis, evaluation, inference, and deductive and inductive reasoning. It is intuitive that nurse managers require both the skills and the dispositions of critical thinking to be successful in this pivotal role at a time of transformation in health care. Incorporating critical thinking into education and support programs for the nurse manager is necessary to position the nurse manager for success.

Modeling Soil Moisture in Support of the Revegetation of Military Lands in Arid Regions.

NASA Astrophysics Data System (ADS)

Caldwell, T. G.; McDonald, E. V.; Young, M. H.

2003-12-01

The National Training Center (NTC), the Army's primary mechanized maneuver training facility, covers approximately 2600 km2 within the Mojave Desert in southern California, and is the subject of ongoing studies to support the sustainability of military lands in desert environments. Revegetation of these lands by the Integrated Training Areas Management (ITAM) Program requires the identification of optimum growing conditions to reestablish desert vegetation from seed and seedling, especially with regard to the timing and abundance of plant-available water. Water content, soil water potential, and soil temperature were continuously monitored and used to calibrate the Simultaneous Heat And Water (SHAW) model at 3 re-seeded sites. Modeled irrigation scenarios were used to further evaluate the most effective volume, frequency, and timing of irrigation required to maximize revegetation success and minimize water use. Surface treatments including straw mulch, gravel mulch, soil tackifier and plastic sheet

Acute liver injury associated with a newer formulation of the herbal weight loss supplement Hydroxycut.

PubMed

Araujo, James L; Worman, Howard J

2015-05-06

Despite the widespread use of herbal and dietary supplements (HDS), serious cases of hepatotoxicity have been reported. The popular herbal weight loss supplement, Hydroxycut, has previously been implicated in acute liver injury. Since its introduction, Hydroxycut has undergone successive transformations in its formulation; yet, cases of liver injury have remained an ongoing problem. We report a case of a 41-year-old Hispanic man who developed acute hepatocellular liver injury with associated nausea, vomiting, jaundice, fatigue and asterixis attributed to the use of a newer formulation of Hydroxycut, SX-7 Clean Sensory. The patient required hospitalisation and improved with supportive therapy. Despite successive transformations in its formulation, potential liver injury appears to remain an ongoing problem with Hydroxycut. Our case illustrates the importance of obtaining a thorough medication history, including HDS, regardless of new or reformulated product marketing efforts. 2015 BMJ Publishing Group Ltd.

Acute liver injury associated with a newer formulation of the herbal weight loss supplement Hydroxycut

PubMed Central

Worman, Howard J

2015-01-01

Despite the widespread use of herbal and dietary supplements (HDS), serious cases of hepatotoxicity have been reported. The popular herbal weight loss supplement, Hydroxycut, has previously been implicated in acute liver injury. Since its introduction, Hydroxycut has undergone successive transformations in its formulation; yet, cases of liver injury have remained an ongoing problem. We report a case of a 41-year-old Hispanic man who developed acute hepatocellular liver injury with associated nausea, vomiting, jaundice, fatigue and asterixis attributed to the use of a newer formulation of Hydroxycut, SX-7 Clean Sensory. The patient required hospitalisation and improved with supportive therapy. Despite successive transformations in its formulation, potential liver injury appears to remain an ongoing problem with Hydroxycut. Our case illustrates the importance of obtaining a thorough medication history, including HDS, regardless of new or reformulated product marketing efforts. PMID:25948859

Understanding bladder management on a palliative care unit: a grounded theory study.

PubMed

Gutmanis, Iris; Hay, Melissa; Shadd, Joshua; Byrne, Janette; McCallum, Sarah; Bishop, Kristen; Whitfield, Patricia; Faulds, Cathy

2017-03-16

Research regarding factors associated with nursing-initiated changes to bladder management at end-of-life is sparse. To explore the process of Palliative Care Unit (PCU) nurses' approach to bladder management changes. Nursing staff from one PCU in London, Canada were interviewed regarding bladder management care practices. A constructivist grounded theory was generated. Four interconnected themes emerged: humanity (compassionate support of patients); journey (making the most of a finite timeline); health condition (illness, functional decline); and context (orders, policies, supplies). These overlapping themes must be considered in light of ongoing changes which prompt recycling through the framework. While bladder management necessitates shared decision-making and individualised care, nurses' phronetic experience may serve to detect the presence of change and the need to consider other alternatives. End-of-life bladder management requires nurses to continually reconsider the significance of humanity, journey, health condition and context in light of ongoing changes.

What about a Disability Rights Act for Canada?: Practices and lessons from America, Australia, and the United Kingdom.

PubMed

Prince, Michael J

2010-01-01

The Harper government and most national political parties are committed to a federal act for dealing with accessibility rights for persons with disabilities. The purpose of this article is to identify progressive lessons from countries with similar legislation for consideration by Canadian authorities. Countries surveyed are the United States, Australia, and the United Kingdom. While disability rights legislation is widely accepted to be a necessary policy initiative in light of ongoing barriers and exclusion, experience suggests that such laws are far from a sufficient response to promote access. Other policy instruments required include supportive employment programs, tax incentives, and the direct provision of basic supports.

InTASC Model Core Teaching Standards and Learning Progressions for Teachers 1.0: A Resource for Ongoing Teacher Development

ERIC Educational Resources Information Center

Council of Chief State School Officers, 2013

2013-01-01

The Council of Chief State School Officers (CCSSO), through its Interstate Teacher Assessment and Support Consortium (InTASC), offers this set of combined resources that define and support ongoing teacher effectiveness to ensure students reach college and career ready standards. This document includes the "InTASC Model Core Teaching…

The effect of aborting ongoing movements on end point position estimation.

PubMed

Itaguchi, Yoshihiro; Fukuzawa, Kazuyoshi

2013-11-01

The present study investigated the impact of motor commands to abort ongoing movement on position estimation. Participants carried out visually guided reaching movements on a horizontal plane with their eyes open. By setting a mirror above their arm, however, they could not see the arm, only the start and target points. They estimated the position of their fingertip based solely on proprioception after their reaching movement was stopped before reaching the target. The participants stopped reaching as soon as they heard an auditory cue or were mechanically prevented from moving any further by an obstacle in their path. These reaching movements were carried out at two different speeds (fast or slow). It was assumed that additional motor commands to abort ongoing movement were required and that their magnitude was high, low, and zero, in the auditory-fast condition, the auditory-slow condition, and both the obstacle conditions, respectively. There were two main results. (1) When the participants voluntarily stopped a fast movement in response to the auditory cue (the auditory-fast condition), they showed more underestimates than in the other three conditions. This underestimate effect was positively related to movement velocity. (2) An inverted-U-shaped bias pattern as a function of movement distance was observed consistently, except in the auditory-fast condition. These findings indicate that voluntarily stopping fast ongoing movement created a negative bias in the position estimate, supporting the idea that additional motor commands or efforts to abort planned movement are involved with the position estimation system. In addition, spatially probabilistic inference and signal-dependent noise may explain the underestimate effect of aborting ongoing movement.

Shared mission operations concept

NASA Technical Reports Server (NTRS)

Spradlin, Gary L.; Rudd, Richard P.; Linick, Susan H.

1994-01-01

Historically, new JPL flight projects have developed a Mission Operations System (MOS) as unique as their spacecraft, and have utilized a mission-dedicated staff to monitor and control the spacecraft through the MOS. NASA budgetary pressures to reduce mission operations costs have led to the development and reliance on multimission ground system capabilities. The use of these multimission capabilities has not eliminated an ongoing requirement for a nucleus of personnel familiar with a given spacecraft and its mission to perform mission-dedicated operations. The high cost of skilled personnel required to support projects with diverse mission objectives has the potential for significant reduction through shared mission operations among mission-compatible projects. Shared mission operations are feasible if: (1) the missions do not conflict with one another in terms of peak activity periods, (2) a unique MOS is not required, and (3) there is sufficient similarity in the mission profiles so that greatly different skills would not be required to support each mission. This paper will further develop this shared mission operations concept. We will illustrate how a Discovery-class mission would enter a 'partner' relationship with the Voyager Project, and can minimize MOS development and operations costs by early and careful consideration of mission operations requirements.

Nutritional status of patients with ataxia-telangiectasia: A case for early and ongoing nutrition support and intervention.

PubMed

Ross, Lynda J; Capra, Sandra; Baguley, Brenton; Sinclair, Kate; Munro, Kate; Lewindon, Peter; Lavin, Martin

2015-08-01

Ataxia-telangiectasia (A-T) is a rare genomic syndrome resulting in severe disability. Chronic childhood disorders can profoundly influence growth and development. Nutrition-related issues in A-T are not well described, and there are no nutritional guidelines. This study investigated the nutrition-related characteristics and behaviours of Australian A-T patients attending a national clinic. A cross-sectional analysis of 13 A-T patients (nine females; aged: 4-23 years): nutritional status was assessed by anthropometric and body cell mass (BCM) calculations. Parents reported their child's diet history and physical and behavioural factors that affect nutrition including fatigue and need for assistance. Ten (77%) had short stature (height for age z scores <-1), and seven (54%) were underweight for height (weight/height z scores <-1). Significant malnutrition (BCM z scores <-2) was detected in nine (69%) including the one adult who was severely malnourished. Malnutrition increased significantly with age (BCM for height z scores and age, r = -0.937, P < 0.001). Eight (62%) patients ate poorly compared with estimated energy requirement for weight. Poor diet quality was characterised by high fat and sugar choices. Parents reported significant nutritional barriers as chronic tiredness and the need for care giver assistance with meals. This study confirms profound malnutrition in Australian A-T patients. Poor intakes and diet quality suggest the need for early nutrition intervention. Ongoing support for families and early discussions on tube feeding are required to address changing needs in childhood and likely nutritional decline into adulthood. A prospective study is required to assess feasibility and effectiveness of nutrition interventions in young people with A-T. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

A patient centered care plan in the EHR: improving collaboration and engagement.

PubMed

Chunchu, Kavitha; Mauksch, Larry; Charles, Carol; Ross, Valerie; Pauwels, Judith

2012-09-01

Patients attempting to manage their chronic conditions require ongoing support in changing and adopting self-management behaviors. However, patient values, health goals, and action plans are not well represented in the electronic health record (EHR) impeding the ability of the team (MA and providers) to provide respectful, ongoing self-management support. We evaluated whether a team approach to using an EHR based patient centered care plan (PCCP) improved collaborative self-management planning. An experimental, prospective cohort study was conducted in a family medicine residency clinic. The experimental group included 7 physicians and a medical assistant who received 2 hr of PCCP training. The control group consisted of 7 physicians and a medical assistant. EHR charts were analyzed for evidence of 8 behavior change elements. Follow-up interviews with experimental group patients and physicians and the medical assistant assessed their experiences. We found that PCCP charts had more documented behavior change elements than control charts in all 8 domains (p < .001). Experimental group physicians valued the PCCP model and suggested ways to improve its use. Patient feedback demonstrated support for the model. A PCCP can help team members to engage patients with chronic illnesses in goal setting and action planning to support self-management. An EHR design that stores patient values, health goals, and action plans may strengthen continuity and quality of care between patients and primary care team members. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Community health workers leading the charge on workforce development: lessons from New Orleans.

PubMed

Wennerstrom, Ashley; Johnson, Liljana; Gibson, Kristina; Batta, Sarah E; Springgate, Benjamin F

2014-12-01

Academic institutions and community organizations engaged community health workers (CHWs) in creating a community-appropriate CHW workforce capacity-building program in an area without a previously established CHW professional group. From 2009 to 2010, we solicited New Orleans-based CHWs' opinions about CHW professional development through a survey, a community conference, and workgroup meetings. Throughout 2011 and 2012, we created and implemented a responsive 80-h workforce development program that used popular education techniques. We interviewed CHWs 6 months post-training to assess impressions of the course and application of skills and knowledge to practice. CHWs requested training to develop nationally-recognized core competencies including community advocacy, addresses issues unique to New Orleans, and mitigate common professional challenges. Thirty-five people completed the course. Among 25 interviewees, common themes included positive impressions of the course, application of skills and community-specific information to practice, understanding of CHWs' historical roles as community advocates, and ongoing professional challenges. Engaging CHW participation in workforce development programs is possible in areas lacking organized CHW groups. CHW insight supports development of training that addresses unique local concerns. Trained CHWs require ongoing professional support.

Supports and Concerns for Teacher Professional Growth During the Implementation of a Science Curriculum Innovation

NASA Astrophysics Data System (ADS)

Peers, Cheryl (Shelley) E.; Diezmann, Carmel M.; Watters, James J.

2003-02-01

Internationally, considerable reform in science education is occurring which promotes constructivist philosophies and advocates constructivist-inspired pedagogical strategies that are new to many teachers. This paper reports on the supporting factors necessary for teacher professional growth and the issues of concern that were evident during one primary teacher''s successful implementation of a unit of work based on a draft of a new state-wide science syllabus which proposes such approaches. One researcher (CEP) provided guidance during the writing and implementation of the unit through professional development workshops complemented by ongoing collegial support. The analysis of the teacher''s practice reveals that professional growth required a willingness of the teacher to engage with change and modify his professional practice. The support factors for teacher growth consisted of an appropriate program of professional development, teacher understanding of the elements of the curriculum innovation, and successful experiences in implementing new approaches. In contrast, the issues of concern were: the adequacy of support for planning including the time required to understand the innovation and make changes to teaching practice; science equipment; teacher knowledge; classroom management strategies; and ways to cope with change. Understanding of these support factors and issues of concern is vital for the successful implementation of science curriculum innovations.

Environmental control medical support team

NASA Technical Reports Server (NTRS)

Crump, William J.; Kilgore, Melvin V., Jr.

1988-01-01

The activities conducted in support of the Environmental Control and Life Support Team during December 7, 1987 through September 30, 1988 are summarized. The majority of the ongoing support has focused on the ECLSS area. Through a series of initial meetings with the ECLSS team and technical literature review, an initial list of critical topics was developed. Subtasks were then identified or additional related tasks received as action items from the ECLSS group meetings. Although most of the efforts focused on providing MSFC personnel with information regarding specific questions and problems related to ECLSS issues, other efforts regarding identifying an ECLSS Medical Support Team and constructing data bases of technical information were also initiated and completed. The specific tasks are as follows: (1) Provide support to the mechanical design and integration of test systems as related to microbiological concerns; (2) Assist with design of Human Subjects Test Protocols; (3) Interpretation and recommendations pertaining to air/water quality requirements; (4) Assist in determining the design specifications required as related to the Technical Demonstration Program; (5) Develop a data base of all microorganisms recovered from previous subsystem testing; (6) Estimates of health risk of individual microbes to test subjects; (7) Assist with setting limits for safety of test subjects; (8) Health monitoring of test subjects; (9) Assist in the preparation of test plans; (10) Assist in the development of a QA/QC program to assure the validity, accuracy and precision of the analyses; and (11) Assist in developing test plans required for future man in the loop testing.

Skills, systems and supports: An Aboriginal Community Controlled Health Service (Apunipima) approach to building health promotion evaluation capacity of staff.

PubMed

Nichols, Nina; McFarlane, Kathryn; Gibson, Priscilla; Millard, Fiona; Packer, Andrew; McDonald, Malcolm

2018-04-01

Building the health promotion evaluation capacity of a workforce requires more than a focus on individual skills and confidence. We must also consider the organisational systems and supports that enable staff to embed learnings into practice. This paper describes the processes used to build health promotion evaluation capacity of staff in an Aboriginal Community Controlled Health Service (ACCHS). To build health promotion evaluation capacity three approaches were used: (i) workshops and mentoring; (ii) strengthening systems to support program reporting; and (iii) recruitment of staff with skills and experience. Pre- and post-questionnaires determined levels of individual skills and confidence, updated systems were assessed for adequacy to support new health promotion practices and surveys captured the usefulness of workshops and mentoring. There was increased participant skills and confidence. Participants completed program impact evaluation reports and results were successfully presented at national conferences. The health promotion team was then able to update in-house systems to support new health promotion practices. Ongoing collaboration with experienced in-house researchers provided basic research training and professional mentoring. Building health promotion evaluation capacity of staff in an ACCHS can be achieved by providing individual skill development, strengthening organisational systems and utilising professional support. SO WHAT?: Health promotion practitioners have an ongoing professional obligation to improve the quality of routine practice and embrace new initiatives. This report outlines a process of building evaluation capacity that promotes quality reporting of program impacts and outcomes, reflects on ways to enhance program strengths, and communicates these findings internally and to outside professional bodies. This is particularly significant for ACCHSs responsible for addressing the high burden of preventable disease in Aboriginal and Torres Strait Islander populations. © 2017 Australian Health Promotion Association.

A strategic vision for telemedicine and medical informatics in space flight

NASA Technical Reports Server (NTRS)

Williams, D. R.; Bashshur, R. L.; Pool, S. L.; Doarn, C. R.; Merrell, R. C.; Logan, J. S.

2000-01-01

This Workshop was designed to assist in the ongoing development and application of telemedicine and medical informatics to support extended space flight. Participants included specialists in telemedicine and medical/health informatics (terrestrial and space) medicine from NASA, federal agencies, academic centers, and research and development institutions located in the United States and several other countries. The participants in the working groups developed vision statements, requirements, approaches, and recommendations pertaining to developing and implementing a strategy pertaining to telemedicine and medical informatics. Although some of the conclusions and recommendations reflect ongoing work at NASA, others provided new insight and direction that may require a reprioritization of current NASA efforts in telemedicine and medical informatics. This, however, was the goal of the Workshop. NASA is seeking other perspectives and views from leading practitioners in the fields of telemedicine and medical informatics to invigorate an essential and high-priority component of the International Space Station and future extended exploration missions. Subsequent workshops will further define and refine the general findings and recommendations achieved here. NASA's ultimate aim is to build a sound telemedicine and medical informatics operational system to provide the best medical care available for astronauts going to Mars and beyond.

A strategic vision for telemedicine and medical informatics in space flight.

PubMed

Williams, D R; Bashshur, R L; Pool, S L; Doarn, C R; Merrell, R C; Logan, J S

2000-01-01

This Workshop was designed to assist in the ongoing development and application of telemedicine and medical informatics to support extended space flight. Participants included specialists in telemedicine and medical/health informatics (terrestrial and space) medicine from NASA, federal agencies, academic centers, and research and development institutions located in the United States and several other countries. The participants in the working groups developed vision statements, requirements, approaches, and recommendations pertaining to developing and implementing a strategy pertaining to telemedicine and medical informatics. Although some of the conclusions and recommendations reflect ongoing work at NASA, others provided new insight and direction that may require a reprioritization of current NASA efforts in telemedicine and medical informatics. This, however, was the goal of the Workshop. NASA is seeking other perspectives and views from leading practitioners in the fields of telemedicine and medical informatics to invigorate an essential and high-priority component of the International Space Station and future extended exploration missions. Subsequent workshops will further define and refine the general findings and recommendations achieved here. NASA's ultimate aim is to build a sound telemedicine and medical informatics operational system to provide the best medical care available for astronauts going to Mars and beyond.

Nuclear Cryogenic Propulsion Stage (NCPS) Fuel Element Testing in the Nuclear Thermal Rocket Element Environmental Simulator (NTREES)

NASA Technical Reports Server (NTRS)

Emrich, William J., Jr.

2017-01-01

To support the on-going nuclear thermal propulsion effort, a state-of-the-art non nuclear experimental test setup has been constructed to evaluate the performance characteristics of candidate fuel element materials and geometries in representative environments. The facility to perform this testing is referred to as the Nuclear Thermal Rocket Element Environment Simulator (NTREES). Last year NTREES was successfully used to satisfy a testing milestone for the Nuclear Cryogenic Propulsion Stage (NCPS) project and met or exceeded all required objectives.

Optimizing Antibiotic Use in Nursing Homes Through Antibiotic Stewardship.

PubMed

Sloane, Philip D; Huslage, Kirk; Kistler, Christine E; Zimmerman, Sheryl

2016-01-01

Antibiotic stewardship is becoming a requirement for nursing homes. Programs should be interdisciplinary and multifaceted; should have support from nursing home administrators; and should aim to promote antibiotics only when needed, not just in case. Recommended components include use of evidence-based guidelines; ongoing monitoring of antibiotic prescriptions, cultures, and study results; monitoring of health outcomes; use of nursing home-specific antibiograms; regular reporting and feedback to medical providers and nurses; and education of residents and families. ©2016 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

Using Coaching to Provide Ongoing Support and Supervision to Out-of-School Time Staff. Part 3 in a Series on Implementing Evidence-Based Practices in Out-of-School Time Programs: The Role of Frontline Staff. Research-to-Results Brief. Publication #2009-06

ERIC Educational Resources Information Center

Burkhauser, Mary; Metz, Allison J. R.

2009-01-01

Although skills needed by out-of-school time practitioners can be introduced during training, many skills can only really be learned on the job with ongoing support and supervision provided by a "coach." Research from both the education and out-of-school time fields supports the value of staff coaching as a professional development tool, and staff…

Patient experience in a coordinated care model featuring diabetes self-management education integrated into the patient-centered medical home.

PubMed

Janiszewski, Debra; O'Brian, Catherine A; Lipman, Ruth D

2015-08-01

The purpose of this study is to gain insight about patient experience of diabetes self-management education in a patient-centered medical home. Six focus groups consisting of 37 people with diabetes, diverse in race and ethnicity, were conducted at 3 sites. Participants described their experience in the program and their challenges in diabetes self-management; they also suggested services to meet their diabetes care needs. The most common theme was ongoing concerns about care and support. There was much discussion about the value of the support provided by health navigators integrated in the diabetes health care team. Frequent concerns expressed by participants centered on personal challenges in engaging in healthy lifestyle behaviors. Ongoing programmatic support of self-management goals was widely valued. Individuals who received health care in a patient-centered medical home and could participate in diabetes self-management education with integrated support valued both activities. The qualitative results from this study suggest need for more formalized exploration of effective means to meet the ongoing support needs of people with diabetes. © 2015 The Author(s).

Anaesthetic management of patients with severe sepsis.

PubMed

Eissa, D; Carton, E G; Buggy, D J

2010-12-01

Severe sepsis, a syndrome characterized by systemic inflammation and acute organ dysfunction in response to infection, is a major healthcare problem affecting all age groups throughout the world. Anaesthetists play a central role in the multidisciplinary management of patients with severe sepsis from their initial deterioration at ward level, transfer to the diagnostic imaging suite, and intraoperative management for emergency surgery. The timely administration of appropriate i.v. antimicrobial therapy is a crucial step in the care of patients with severe sepsis who may require surgery to control the source of sepsis. Preoperative resuscitation, aimed at optimizing major organ perfusion, is based on judicious use of fluids, vasopressors, and inotropes. Intraoperative anaesthesia management requires careful induction and maintenance of anaesthesia, optimizing intravascular volume status, avoidance of lung injury during mechanical ventilation, and ongoing monitoring of arterial blood gases, lactate concentration, haematological and renal indices, and electrolyte levels. Postoperative care overlaps with ongoing management of the severe sepsis syndrome patient in the intensive care unit. These patients are by definition, high risk, already requiring multiple supports, and require experienced and skilful decision-making to optimize their chances of a favourable outcome. Similar to acute myocardial infarction, stroke, or acute trauma, the initial hours (golden hours) of clinical management of severe sepsis represent an important opportunity to reduce morbidity and mortality. Rapid clinical assessment, resuscitation and surgical management by a focused multidisciplinary team, and early effective antimicrobial therapy are the key components to improved patient outcome.

In Situ Resource Utilization Technology Research and Facilities Supporting the NASA's Human Systems Research and Technology Life Support Program

NASA Technical Reports Server (NTRS)

Schlagheck, Ronald A.; Sibille, Laurent; Sacksteder, Kurt; Owens, Chuck

2005-01-01

The NASA Microgravity Science program has transitioned research required in support of NASA s Vision for Space Exploration. Research disciplines including the Materials Science, Fluid Physics and Combustion Science are now being applied toward projects with application in the planetary utilization and transformation of space resources. The scientific and engineering competencies and infrastructure in these traditional fields developed at multiple NASA Centers and by external research partners provide essential capabilities to support the agency s new exploration thrusts including In-Situ Resource Utilization (ISRU). Among the technologies essential to human space exploration, the production of life support consumables, especially oxygen and; radiation shielding; and the harvesting of potentially available water are realistically achieved for long-duration crewed missions only through the use of ISRU. Ongoing research in the physical sciences have produced a body of knowledge relevant to the extraction of oxygen from lunar and planetary regolith and associated reduction of metals and silicon for use meeting manufacturing and repair requirements. Activities being conducted and facilities used in support of various ISRU projects at the Glenn Research Center and Marshall Space Flight Center will be described. The presentation will inform the community of these new research capabilities, opportunities, and challenges to utilize their materials, fluids and combustion science expertise and capabilities to support the vision for space exploration.

Transforming youth mental health services and supports in Ireland.

PubMed

Illback, Robert J; Bates, Tony

2011-02-01

Young people in the Republic of Ireland do not have access to appropriate mental health services and supports, necessitating transformational change in delivery systems. Describe ongoing development and change efforts facilitated by Headstrong--The National Centre for Youth Mental Health. Discusses findings from a national needs assessment, core strategies within the change initiative, progress in system-building, and preliminary descriptive and outcome data. Five demonstration sites comprised of four counties and a city neighbourhood are operational and preliminary data are promising with respect to implementation and outcomes. Effective change initiatives require vision and leadership, competence- and capacity-building, participative planning and engagement, adequate and thoughtfully deployed resources, and a comprehensive change management approach. © 2011 Blackwell Publishing Asia Pty Ltd.

Accumulating Evidence about What Prospective Memory Costs Actually Reveal

ERIC Educational Resources Information Center

Strickland, Luke; Heathcote, Andrew; Remington, Roger W.; Loft, Shayne

2017-01-01

Event-based prospective memory (PM) tasks require participants to substitute an atypical PM response for an ongoing task response when presented with PM targets. Responses to ongoing tasks are often slower with the addition of PM demands ("PM costs"). Prominent PM theories attribute costs to capacity-sharing between the ongoing and PM…

CHANGING HEALTH TECHNOLOGY ASSESSMENT PARADIGMS?

PubMed

Husereau, Don; Henshall, Chris; Sampietro-Colom, Laura; Thomas, Sarah

2016-01-01

Health technology assessment (HTA) has to innovate to best support changing health system environments and to help provide access to valuable innovation under fiscal constraint. Issues associated with changing HTA paradigms were identified through scoping and explored through deliberation at a meeting of industry and HTA leaders. Five broad areas of change (engagement, scientific dialogue, research prioritization, adaptive approaches, and real world data) were identified. The meeting focused on two themes derived from these: re-thinking scientific dialogue and multi-stakeholder engagement, and re-thinking value, affordability, and access. Earlier and ongoing engagement to steer the innovation process and help achieve appropriate use across the technology lifecycle was perceived as important but would be resource intensive and would require priority setting. Patients need to be involved throughout, and particularly at the early stages. Further discussion is needed on the type of body best suited to convening the dialogue required. There was agreement that HTA must continue to assess value, but views differed on the role that HTA should play in assessing affordability and on appropriate responses to challenges around affordability. Enhanced horizon scanning could play an important role in preparing for significant future investments. Early and ongoing multi-stakeholder engagement and revisiting approaches to valuing innovation are required. Questions remain as to the most appropriate role for HTA bodies. Changing HTA paradigms extend HTA's traditional remit of being responsive to decision-makers demands to being more proactive and considering whole system value.

Developing a Capstone Course within a Health Informatics Program

PubMed Central

Hackbarth, Gary; Cata, Teuta; Cole, Laura

2012-01-01

This article discusses the ongoing development of a health informatics capstone program in a Midwest university from the hiring of a program coordinator to the development of a capstone course, through initial student results. University health informatics programs require a strong academic program to be successful but also require a spirited program coordinator to manage resources and organize an effective capstone course. This is particularly true of health informatics master's programs that support health industry career fields, whereby employers can locate and work with a pool of qualified applicants. The analysis of students’ logs confirms that students’ areas of focus and concern are consistent with course objectives and company work requirements during the work-study portion of the student capstone project. The article further discusses lessons learned and future improvements to be made in the health informatics capstone course. PMID:22783150

Deep ocean corrosion research in support of Oman India gas pipeline

DOE Office of Scientific and Technical Information (OSTI.GOV)

Graham, F.W.; McKeehan, D.S.

1995-12-01

The increasing interest in deepwater exploration and production has motivated the development of technologies required to accomplish tasks heretofore possible only onshore and in shallow water. The tremendous expense of technology development and the cost of specialized equipment has created concerns that the design life of these facilities may be compromised by corrosion. The requirements to develop and prove design parameters to meet these demands will require an ongoing environmental testing and materials evaluation and development program. This paper describes a two-fold corrosion testing program involving: (1) the installation of two corrosion test devices installed in-situ, and (2) a laboratorymore » test conducted in simulated site-specific seawater. These tests are expected to qualify key parameters necessary to design a cathodic protection system to protect the Oman-to-India pipeline.« less

"No one has yet properly articulated what we are trying to achieve": a discourse analysis of interviews with revalidation policy leaders in the United Kingdom.

PubMed

Archer, Julian; Regan de Bere, Sam; Nunn, Suzanne; Clark, Jonathan; Corrigan, Oonagh

2015-01-01

To analyze prevailing definitions of revalidation (i.e., a recently instituted system of ongoing review for all physicians in the United Kingdom), the circumstances of their origin, and proposed applications, after a protracted and sometimes difficult decade in development. This was to support a more consensual approach to revalidation policy before its launch in 2012. In 2010 and 2011, the authors carried out a critical discourse analysis of interviews with 31 medical and legal revalidation policy makers. These individuals represented the main stakeholder bodies, including the General Medical Council, Academy of Medical Royal Colleges, British Medical Association, National Health Service Employers, and the departments of health from across the United Kingdom. The authors identified two overarching discourses: regulation and professionalism, held together by patients as "discursive glue." Regulation frames revalidation as a way to identify "bad apples," requiring a summative approach and minimum standards. Professionalism looks to revalidation as a process by which all doctors improve, requiring evolving standards and a developmental model. These two discourses were not mutually exclusive; indeed, most interviewees used them interchangeably. However, they are in some regards at odds. Their coexistence has been supported by a shared discursive formation around patients. Yet the authors found little patient-centered policy in revalidation in its current form. The authors concluded that patients need to be recognized, making them present with an active voice. They also stressed the importance of established and ongoing evaluation of medical regulation as a policy and process.

Are telehealth technologies for hypertension care and self-management effective or simply risky and costly?

PubMed

McKoy, June; Fitzner, Karen; Margetts, Miranda; Heckinger, Elizabeth; Specker, James; Roth, Laura; Izenberg, Maxwell; Siegel, Molly; McKinney, Shannon; Moss, Gail

2015-06-01

Hypertension is a prevalent chronic disease that requires ongoing management and self-care. The disease affects 31% of American adults and contributed to or caused the deaths of 348,000 Americans in 2008, fewer than 50% of whom effectively self-managed the disease. However, self-management is complex, with patients requiring ongoing support and easy access to care. Telehealth may help foster the knowledge and skills necessary for those with hypertension to engage in successful self-management. This paper considers the applicability, efficacy, associated risks, and cost-effectiveness of telehealth for individuals and populations with hypertension. Telehealth is a broad term, encompassing telemedicine and mobile health that is used for physician-patient interactions, diagnostics, care delivery, education, information sharing, monitoring, and reminders. Telemedicine may have considerable utility for people diagnosed with hypertension who have poor access or social barriers that constrain access, but potential risks exist. Telehealth technology is evolving rapidly, even in the absence of fully proven cost-effectiveness and efficacy. Considering the cost of inpatient and emergency department care for patients with hypertension, telehealth is a highly attractive alternative, but there are risks to consider. Incorporating telehealth, which is increasingly characterized by mobile health, can increase both the capacity of health care providers and the reach of patient support, clinical management, and self-care. Telehealth studies need improvement; long-term outcome data on cardiovascular events must be obtained, and robust risk analyses and economic studies are needed to prospectively evaluate the safety and cost savings for hypertension self-management.

mHealth 2.0: Experiences, Possibilities, and Perspectives

PubMed Central

Diamantidis, Clarissa

2014-01-01

With more than 1 billion users having access to mobile broadband Internet and a rapidly growing mobile app market, all stakeholders involved have high hopes that this technology may improve health care. Expectations range from overcoming structural barriers to access in low-income countries to more effective, interactive treatment of chronic conditions. Before medical health practice supported by mobile devices ("mHealth") can scale up, a number of challenges need to be adequately addressed. From a psychological perspective, high attrition rates, digital divide of society, and intellectual capabilities of the users are key issues when implementing such technologies. Furthermore, apps addressing behavior change often lack a comprehensive concept, which is essential for an ongoing impact. From a clinical point of view, there is insufficient evidence to allow scaling up of mHealth interventions. In addition, new concepts are required to assess the efficacy and efficiency of interventions. Regarding technology interoperability, open standards and low-energy wireless protocols appear to be vital for successful implementation. There is an ongoing discussion in how far health care-related apps require a conformity assessment and how to best communicate quality standards to consumers. "Apps Peer-Review" and standard reporting via an "App synopsis" appear to be promising approaches to increase transparency for end users. With respect to development, more emphasis must be placed on context analysis to identify what generic functions of mobile information technology best meet the needs of stakeholders involved. Hence, interdisciplinary alliances and collaborative strategies are vital to achieve sustainable growth for "mHealth 2.0," the next generation mobile technology to support patient care. PMID:25099752

Optimizing identification and management of COPD patients – reviewing the role of the community pharmacist

PubMed Central

van Boven, Job F. M.; Maguire, Terence; Goyal, Pankaj; Altman, Pablo

2016-01-01

The aim of this paper was to propose key steps for community pharmacist integration into a patient care pathway for chronic obstructive pulmonary disease (COPD) management. A literature search was conducted to identify publications focusing on the role of the community pharmacist in identification and management of COPD. The literature search highlighted evidence supporting an important role for pharmacists at each of the four key steps in the patient care pathway for COPD management. Step 1 (primary prevention): pharmacists are ideally placed to provide information on disease awareness and risk prevention campaigns, and to encourage lifestyle interventions, including smoking cessation. Step 2 (early detection/case finding): pharmacists are often the first point of contact between the patient and the healthcare system and can therefore play an important role in the early identification of patients with COPD. Step 3 (management and ongoing support): pharmacists can assist patients by providing advice and education on dosage, inhaler technique, treatment expectations and the importance of adherence, and by supporting self‐management, including recognition and treatment of COPD exacerbations. Step 4 (review and follow‐up): pharmacists can play an important role in monitoring adherence and ongoing inhaler technique in patients with COPD. In summary, pharmacists are ideally positioned to play a vital role in all key stages of an integrated COPD patient care pathway from early disease detection to the support of management plans, including advice and counselling regarding medications, inhaler technique and treatment adherence. Areas requiring additional consideration include pharmacist training, increasing awareness of the pharmacist role, administration and reimbursement, and increasing physician–pharmacist collaboration. PMID:27510273

Perspectives of Australian nursing directors regarding educational preparation for mental health nursing practice.

PubMed

Happell, Brenda; McAllister, Margaret

2014-11-01

There is an ongoing global shortage of mental health nurses. Within Australia, the principal strategy of offering a postgraduate education programme with various incentives to encourage nurses back to study has not been successful. This has led to the consideration of radical alternatives, including the return to pre-registration specialisation in mental health. The successful introduction of this strategy would require the full support of industry partners. To date, the voice of industry has not been heard in relation to this issue. The aim of this paper is to present the views of an Australian sample of mental health nursing directors regarding the resources and other factors required, should undergraduate specialist programmes in mental health be developed, to ensure they are relevant and likely to be successful. A qualitative exploratory research project was undertaken to explore the perspectives and opinions of industry partners. In-depth interviews were conducted with nursing directors (n = 12) in Queensland Australia. Five main themes were identified: relationships with universities; clinical placement preparation and support; workplace culture; facilitators and preceptors; and practical student learning. Genuine collaboration between the two organisations was considered crucial for delivering a quality programme and providing the required support for students. Transformative leadership could inform this collaboration by promoting acknowledgement of and respect for differences.

Implementation of a configurable laboratory information management system for use in cellular process development and manufacturing.

PubMed

Russom, Diana; Ahmed, Amira; Gonzalez, Nancy; Alvarnas, Joseph; DiGiusto, David

2012-01-01

Regulatory requirements for the manufacturing of cell products for clinical investigation require a significant level of record-keeping, starting early in process development and continuing through to the execution and requisite follow-up of patients on clinical trials. Central to record-keeping is the management of documentation related to patients, raw materials, processes, assays and facilities. To support these requirements, we evaluated several laboratory information management systems (LIMS), including their cost, flexibility, regulatory compliance, ongoing programming requirements and ability to integrate with laboratory equipment. After selecting a system, we performed a pilot study to develop a user-configurable LIMS for our laboratory in support of our pre-clinical and clinical cell-production activities. We report here on the design and utilization of this system to manage accrual with a healthy blood-donor protocol, as well as manufacturing operations for the production of a master cell bank and several patient-specific stem cell products. The system was used successfully to manage blood donor eligibility, recruiting, appointments, billing and serology, and to provide annual accrual reports. Quality management reporting features of the system were used to capture, report and investigate process and equipment deviations that occurred during the production of a master cell bank and patient products. Overall the system has served to support the compliance requirements of process development and phase I/II clinical trial activities for our laboratory and can be easily modified to meet the needs of similar laboratories.

Successful Completion of FY18/Q1 ASC L2 Milestone 6355: Electrical Analysis Calibration Workflow Capability Demonstration.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Copps, Kevin D.

The Sandia Analysis Workbench (SAW) project has developed and deployed a production capability for SIERRA computational mechanics analysis workflows. However, the electrical analysis workflow capability requirements have only been demonstrated in early prototype states, with no real capability deployed for analysts’ use. This milestone aims to improve the electrical analysis workflow capability (via SAW and related tools) and deploy it for ongoing use. We propose to focus on a QASPR electrical analysis calibration workflow use case. We will include a number of new capabilities (versus today’s SAW), such as: 1) support for the XYCE code workflow component, 2) data managementmore » coupled to electrical workflow, 3) human-in-theloop workflow capability, and 4) electrical analysis workflow capability deployed on the restricted (and possibly classified) network at Sandia. While far from the complete set of capabilities required for electrical analysis workflow over the long term, this is a substantial first step toward full production support for the electrical analysts.« less

Report on Partial Findings of an Ongoing Research: Social Networking Sites (SNS) as a Platform to Support Teaching and Learning in Secondary Schools

ERIC Educational Resources Information Center

Bt. Ubaidullah, Nor Hasbiah; Samsuddin, Khairulanuar; Bt. Fabil, Norsikin; Bt. Mahadi, Norhayati

2011-01-01

This paper reports the partial findings of a survey that was carried out in the analysis phase of an ongoing research for the development of a prototype of a Social Networking Site (SNS) to support teaching and learning in secondary schools. For the initial phase of the study, a quantitative research method was used based on a survey involving 383…

The neonatal nurses' view of their role in emotional support of parents and its complexities.

PubMed

Turner, Melanie; Chur-Hansen, Anna; Winefield, Helen

2014-11-01

To explore the nurses' views of their role both in the neonatal intensive care unit and in the provision of interacting with, and emotionally supporting, families. The neonatal intensive care nurse has a large and complex clinical role and also a role of emotional supporter for parents in the neonatal intensive care unit. Identifying components of their role and recognising the elements within the nursery that obstruct or encourage this role can allow for modification of nurse education and peer support. Qualitative study based on semistructured interviews. Nine neonatal nurses from a single neonatal intensive care unit were interviewed and the data analysed thematically using NVIVO version 10. Participants viewed their role as an enjoyable yet difficult one, requiring seniority, training and experience. They provided support to parents by communicating, listening, providing individualised support and by encouraging parental involvement with their baby. Constructive elements that contributed to the provision of support included a positive neonatal intensive care unit environment and providing a parent support group. More obstructive elements were a lack of physical neonatal intensive care unit space, little time available for nurse-to-parent conversation and language and cultural barriers between nurses and parents. The role of the neonatal nurse in providing emotional support is complex and requires a high level of ongoing support and education for staff, and minimisation of physical and staff-related obstructions. The modern neonatal intensive care unit offers complex medical and nursing services and with this care comes higher needs from both babies and their parents. Neonatal intensive care unit nurses should be supported in their roles by having peer support available in the neonatal intensive care unit and education and training in emotional support and counselling skills. The nursing staff also require a comfortable and practical physical working space in which to assist parents to be with their baby. © 2014 John Wiley & Sons Ltd.

Strategies to successfully recruit and engage clinical nurses as participants in qualitative clinical research.

PubMed

Coyne, Elisabeth; Grafton, Eileen; Reid, Alayne

2016-12-01

Research conducted in the clinical area promotes the delivery of evidence-based patient care. Involving nurses as participants in research is considered essential to link patient care with evidence-based interventions. However recruitment is influenced by nurses' competing demands and understanding engagement strategies may assist future research. This reflective analysis aimed to understand influencing factors and strategies that support successful recruitment nurses in clinical research. A reflective analysis of research notes and focus group data from research with oncology nurses was completed. This research identified that gaining support from key staff, understanding work constraints and developing a rapport with nurses is important. Establishing clear relevance and benefits of the research and being flexible with research requirements enabled nurses to participate in the research. Clear information and a willingness to accommodate the demands and dynamic nature of the environment, ensures ongoing support and engagement of nurses in the clinical setting as participants in research.

F Reactor Inspection

ScienceCinema

Grindstaff, Keith; Hathaway, Boyd; Wilson, Mike

2018-01-16

Workers from Mission Support Alliance, LLC., removed the welds around the steel door of the F Reactor before stepping inside the reactor to complete its periodic inspection. This is the first time the Department of Energy (DOE) has had the reactor open since 2008. The F Reactor is one of nine reactors along the Columbia River at the Department's Hanford Site in southeastern Washington State, where environmental cleanup has been ongoing since 1989. As part of the Tri-Party Agreement, the Department completes surveillance and maintenance activities of cocooned reactors periodically to evaluate the structural integrity of the safe storage enclosure and to ensure confinement of any remaining hazardous materials. "This entry marks a transition of sorts because the Hanford Long-Term Stewardship Program, for the first time, was responsible for conducting the entry and surveillance and maintenance activities," said Keith Grindstaff, Energy Department Long-Term Stewardship Program Manager. "As the River Corridor cleanup work is completed and transitioned to long-term stewardship, our program will manage any on-going requirements."

F Reactor Inspection

DOE Office of Scientific and Technical Information (OSTI.GOV)

Grindstaff, Keith; Hathaway, Boyd; Wilson, Mike

2014-10-29

Workers from Mission Support Alliance, LLC., removed the welds around the steel door of the F Reactor before stepping inside the reactor to complete its periodic inspection. This is the first time the Department of Energy (DOE) has had the reactor open since 2008. The F Reactor is one of nine reactors along the Columbia River at the Department's Hanford Site in southeastern Washington State, where environmental cleanup has been ongoing since 1989. As part of the Tri-Party Agreement, the Department completes surveillance and maintenance activities of cocooned reactors periodically to evaluate the structural integrity of the safe storage enclosuremore » and to ensure confinement of any remaining hazardous materials. "This entry marks a transition of sorts because the Hanford Long-Term Stewardship Program, for the first time, was responsible for conducting the entry and surveillance and maintenance activities," said Keith Grindstaff, Energy Department Long-Term Stewardship Program Manager. "As the River Corridor cleanup work is completed and transitioned to long-term stewardship, our program will manage any on-going requirements."« less

Enhancing the Practicum Experience for Pre-service Chemistry Teachers Through Collaborative CoRe Design with Mentor Teachers

NASA Astrophysics Data System (ADS)

Hume, Anne; Berry, Amanda

2013-10-01

This paper reports findings from an ongoing study exploring how the Content Representation (CoRe) design can be used as a tool to help chemistry student teachers begin acquiring the professional knowledge required to become expert chemistry teachers. Phase 2 of the study, reported in this paper, investigated how collaboration with school-based mentors (associate teachers) on teaching practice (practicum) might impact on this process and student teachers' development of their pedagogical content knowledge (PCK). The collaboration involved identifying and discussing pedagogical issues related to a practicum-teaching topic using a student teacher's draft CoRe as a starting point and ongoing focus for the professional dialogue. Practicum offered an opportunity for aspects of student teachers' PCK, as embodied in their draft CoRes, to be explored and expanded upon in classroom programmes with the support and input of associate teachers. The findings were influenced by different contextual factors; however, the student teachers found their CoRes to be very useful frameworks for engaging in focussed professional dialogue with their teaching mentors. They valued the expertise, currency of knowledge and mentoring of their associates and reported positively about the contribution this support made to their PCK development via the CoRe design process and the transformation of the CoRe into classroom teaching.

Impact of land use on the biodiversity integrity of the moist sub-biome of the grassland biome, South Africa.

PubMed

O'Connor, T G; Kuyler, P

2009-01-01

South Africa's moist grassland harbours globally significant biodiversity, supplies essential ecosystem services, supports crop and livestock agriculture, forestry and settlement, yet is poorly conserved. Ongoing transformation and limited opportunity for expanding the protected area network require instead that biodiversity conservation is 'mainstreamed' within other land uses. This exercise sought to identify the relative compatibility of 10 land uses (conservation, livestock or game ranching, tourism/recreation, rural settlement, dryland cropping, irrigated cropping, dairy farming, plantation forestry, and urban settlement) with maintaining biodiversity integrity. This was assessed using 46 indicators for biodiversity integrity that covered landscape composition, structure, and functioning. Data was integrated into a single measure per land use through application of the analytic hierarchy process, with supporting information gained from interviews with experts. The rank order of importance amongst indicators was landscape structure, functioning and composition. Consistent differences among land uses for all three categories revealed two clear groupings. Conservation, livestock or game ranching had the lowest impact and retained substantial natural asset, while that for tourism/recreation was intermediate. All other land uses had a severe impact. Impact on biodiversity integrity depended mainly on the extent of transformation and fragmentation, which accounted for the greatest impact on habitats and species, and impairment of landscape functioning. It is suggested that a strategic intervention for maintaining biodiversity integrity of moist grassland is to support livestock or game ranching and limit ongoing urban sprawl.

Coaching mental health peer advocates for rural LGBTQ people.

PubMed

Willging, Cathleen E; Israel, Tania; Ley, David; Trott, Elise M; DeMaria, Catherine; Joplin, Aaron; Smiley, Verida

Lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) people are affected by mental health disparities, especially in rural communities. We trained peer advocates in rural areas in the fundamentals of mental health, outreach, education, and support for this population. The peer advocates were coached by licensed mental health professionals. We evaluated this process through iterative qualitative analysis of semi-structured interviews and written logs from coaches and advocates. The six major themes comprising the results centered on (1) coaching support, (2) peer advocate skills and preparation, (3) working with help seekers, (4) negotiating diversity, (5) logistical challenges in rural contexts, and (6) systemic challenges. We concluded that peer advocacy for LGBTQ people with mental distress offers an affirmative, community-based strategy to assist the underserved. To be successful, however, peer advocates will likely require ongoing training, coaching, and infrastructural support to negotiate contextual factors that can influence provision of community resources and support to LGBTQ people within rural communities.

Promoting Reflective Physics Teaching Through the Use of Collaborative Learning Annotation System

NASA Astrophysics Data System (ADS)

Milner-Bolotin, Marina

2018-05-01

Effective physics teaching requires extensive knowledge of physics, relevant pedagogies, and modern educational technologies that can support student learning. Acquiring this knowledge is a challenging task, considering how fast modern technologies and expectations of student learning outcomes and of teaching practices are changing Therefore 21st-century physics teachers should be supported in developing a different way of thinking about technology-enhanced physics teaching and learning. We call it Deliberate Pedagogical Thinking with Technology, and base it on the original Pedagogical Content Knowledge and Technological Pedagogical Content Knowledge frameworks. However, unlike the two aforementioned frameworks, the Deliberate Pedagogical Thinking with Technology emphasizes not only teachers' knowledge, but also their attitudes and dispositions about using digital tools in order to support student learning. This paper examines how an online system that allows an ongoing discussion of videos uploaded on it by the students can support reflection in physics teacher education. Examples of using such a system in physics teacher education and teacher-candidates' feedback on their experiences with it are also discussed.

Coaching mental health peer advocates for rural LGBTQ people

PubMed Central

Willging, Cathleen E.; Israel, Tania; Ley, David; Trott, Elise M.; DeMaria, Catherine; Joplin, Aaron; Smiley, Verida

2016-01-01

Lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) people are affected by mental health disparities, especially in rural communities. We trained peer advocates in rural areas in the fundamentals of mental health, outreach, education, and support for this population. The peer advocates were coached by licensed mental health professionals. We evaluated this process through iterative qualitative analysis of semi-structured interviews and written logs from coaches and advocates. The six major themes comprising the results centered on (1) coaching support, (2) peer advocate skills and preparation, (3) working with help seekers, (4) negotiating diversity, (5) logistical challenges in rural contexts, and (6) systemic challenges. We concluded that peer advocacy for LGBTQ people with mental distress offers an affirmative, community-based strategy to assist the underserved. To be successful, however, peer advocates will likely require ongoing training, coaching, and infrastructural support to negotiate contextual factors that can influence provision of community resources and support to LGBTQ people within rural communities. PMID:27458498

Pregnancy and Parenting Support for Incarcerated Women: Lessons Learned

PubMed Central

Shlafer, Rebecca J.; Gerrity, Erica; Duwe, Grant

2017-01-01

Background There are more than 200,000 incarcerated women in U.S. prisons and jails, and it is estimated that 6% to 10% are pregnant. Pregnant incarcerated women experience complex risks that can compromise their health and the health of their offspring. Objectives Identify lessons learned from a community–university pilot study of a prison-based pregnancy and parenting support program. Methods A community–university–corrections partnership was formed to provide education and support to pregnant incarcerated women through a prison-based pilot program. Evaluation data assessed women’s physical and mental health concerns and satisfaction with the program. Between October 2011 and December 2012, 48 women participated. Lessons Learned We learned that providing services for pregnant incarcerated women requires an effective partnership with the Department of Corrections, adaptations to traditional community-based participatory research (CBPR) approaches, and resources that support both direct service and ongoing evaluation. Conclusions Effective services for pregnant incarcerated women can be provided through a successful community– university–corrections partnership. PMID:26548788

Guide to Modelling & Simulation (M&S) for NATO Network-Enabled Capability (M&S for NNEC) (Guide de la modelisation et de la simulation (M&S) pour las NATO network-enabled capability (M&S de la NNEC))

DTIC Science & Technology

2010-02-01

interdependencies, and then modifying plans according to updated projections. This is currently an immature area where further research is required. The...crosscutting.html. [7] Zeigler, B.P. and Hammonds, P. (2007). “Modelling and Simulation- Based Data Engineering: Introducing Pragmatics and Ontologies for...the optimum benefit to be obtained and while immature , ongoing research needs to be maintained. 20) Use of M&S to support complex operations needs

7 CFR 1710.204 - Filing requirements for borrowers that must maintain an approved load forecast on an ongoing basis.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 11 2010-01-01 2010-01-01 false Filing requirements for borrowers that must maintain an approved load forecast on an ongoing basis. 1710.204 Section 1710.204 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE GENERAL AND PRE-LOAN POLICIES AND PROCEDURES COMMON TO...

A Virtual Laboratory for the 4 Bed Molecular Sieve of the Carbon Dioxide Removal Assembly

NASA Technical Reports Server (NTRS)

Coker, Robert; Knox, James; O'Connor, Brian

2016-01-01

Ongoing work to improve water and carbon dioxide separation systems to be used on crewed space vehicles combines sub-scale systems testing and multi-physics simulations. Thus, as part of NASA's Advanced Exploration Systems (AES) program and the Life Support Systems Project (LSSP), fully predictive COMSOL Multiphysics models of the Four Bed Molecular Sieve (4BMS) of the Carbon Dioxide Removal Assembly (CDRA) on the International Space Station (ISS) have been developed. This Virtual Laboratory is being used to help reduce mass, power, and volume requirements for exploration missions. In this paper we describe current and planned modeling developments in the area of carbon dioxide removal to support future missions as well as the resolution of anomalies observed in the ISS CDRA.

Benefits and challenges of health information systems for operations research: an illustrative example to improve surgical scheduling.

PubMed

Chow, Vincent S; Huang, Wenhai; Puterman, Martin L

2009-01-01

Operations research (OR) is playing an increasing role in the support of many health care initiatives. However one of the main challenges facing OR practitioners is the availability and the integrity of operations data. Hospital information systems (HIS) are often designed with a clinical or accounting focus and may lack the data necessary for operational studies. In this paper, we illustrate the data processing methods and data challenges faced by our team during a study of surgical scheduling practices at the Vancouver Island Health Authority. We also provide some general recommendations to improve HIS from an operations perspective. In general, more integration between operations researchers and HIS specialists are required to support ongoing operational improvements in the health care sector.

Reforming funding for chronic illness: Medicare-CDM.

PubMed

Swerissen, Hal; Taylor, Michael J

2008-02-01

Chronic diseases are a major challenge for the Australian health care system in terms of both the provision of quality care and expenditure, and these challenges will only increase in the future. Various programs have been instituted under the Medicare system to provide increased funding for chronic care, but essentially these programs still follow the traditional fee-for-service model. This paper proposes a realignment and extension of current Medicare chronic disease management programs into a framework that provides general practitioners and other health professionals with the necessary "tools" for high quality care planning and ongoing management, and incorporating international models of outcome-linked funding. The integration of social support services with the Medicare system is also a necessary step in providing high quality care for patients with complex needs requiring additional support.

An update on MS Nurse PROfessional, an ongoing project of the European Multiple Sclerosis Platform.

PubMed

Winslow, Anne

2016-12-01

Within the multidisciplinary team required to manage people with multiple sclerosis (MS) effectively, the nurse is the central component of coordinated care and support. A 2009 survey led by the European Multiple Sclerosis Platform, an umbrella organization of national MS associations, identified variance and disparity across Europe in the nursing care of MS patients. This led to development of MS Nurse PROfessional, a continuing medical education-accredited modular online learning program endorsed and approved by leading international nursing and professional groups, and people with MS, as a tool to support the evolving role of the European MS nurse. Analysis of participant experience and nurse practice to date has been overwhelmingly positive. Expansion of MS Nurse PRO is underway or planned for future.

Analysis of Issues for Project Scheduling by Multiple, Dispersed Schedulers (distributed Scheduling) and Requirements for Manual Protocols and Computer-based Support

NASA Technical Reports Server (NTRS)

Richards, Stephen F.

1991-01-01

Although computerized operations have significant gains realized in many areas, one area, scheduling, has enjoyed few benefits from automation. The traditional methods of industrial engineering and operations research have not proven robust enough to handle the complexities associated with the scheduling of realistic problems. To address this need, NASA has developed the computer-aided scheduling system (COMPASS), a sophisticated, interactive scheduling tool that is in wide-spread use within NASA and the contractor community. Therefore, COMPASS provides no explicit support for the large class of problems in which several people, perhaps at various locations, build separate schedules that share a common pool of resources. This research examines the issue of distributing scheduling, as applied to application domains characterized by the partial ordering of tasks, limited resources, and time restrictions. The focus of this research is on identifying issues related to distributed scheduling, locating applicable problem domains within NASA, and suggesting areas for ongoing research. The issues that this research identifies are goals, rescheduling requirements, database support, the need for communication and coordination among individual schedulers, the potential for expert system support for scheduling, and the possibility of integrating artificially intelligent schedulers into a network of human schedulers.

Tissue Engineering of Blood Vessels: Functional Requirements, Progress, and Future Challenges.

PubMed

Kumar, Vivek A; Brewster, Luke P; Caves, Jeffrey M; Chaikof, Elliot L

2011-09-01

Vascular disease results in the decreased utility and decreased availability of autologus vascular tissue for small diameter (< 6 mm) vessel replacements. While synthetic polymer alternatives to date have failed to meet the performance of autogenous conduits, tissue-engineered replacement vessels represent an ideal solution to this clinical problem. Ongoing progress requires combined approaches from biomaterials science, cell biology, and translational medicine to develop feasible solutions with the requisite mechanical support, a non-fouling surface for blood flow, and tissue regeneration. Over the past two decades interest in blood vessel tissue engineering has soared on a global scale, resulting in the first clinical implants of multiple technologies, steady progress with several other systems, and critical lessons-learned. This review will highlight the current inadequacies of autologus and synthetic grafts, the engineering requirements for implantation of tissue-engineered grafts, and the current status of tissue-engineered blood vessel research.

Role of total artificial heart in the management of heart transplant rejection and retransplantation: case report and review.

PubMed

Kalya, Anantharam; Jaroszewski, Dawn; Pajaro, Octavio; Scott, Robert; Gopalan, Radha; Kasper, Diane; Arabia, Francisco

2013-01-01

Cardiac allograft rejection and failure may require mechanical circulatory support as bridge-to-retransplantation. Prognosis in this patient group is poor and implantable ventricular assist devices have had limited success due to organ failure associated with the high dose immunosuppression required to treat ongoing rejection. We present a case from our institution and the world-wide experience utilizing the SynCardia CardioWest Total Artificial Heart (TAH-t; SynCardia Systems, Inc., Tucson, AZ, USA) for replacement of the failing graft, recovery of patient and end-organ failure with ultimate bridge to retransplantation. We present our experience and review of world-wide experience for use of TAH-t in this type patient. © 2013 John Wiley & Sons A/S.

Support of an Active Science Project by a Large Information System: Lessons for the EOS Era

NASA Technical Reports Server (NTRS)

Angelici, Gary L.; Skiles, J. W.; Popovici, Lidia Z.

1993-01-01

The ability of large information systems to support the changing data requirements of active science projects is being tested in a NASA collaborative study. This paper briefly profiles both the active science project and the large information system involved in this effort and offers some observations about the effectiveness of the project support. This is followed by lessons that are important for those participating in large information systems that need to support active science projects or that make available the valuable data produced by these projects. We learned in this work that it is difficult for a large information system focused on long term data management to satisfy the requirements of an on-going science project. For example, in order to provide the best service, it is important for all information system staff to keep focused on the needs and constraints of the scientists in the development of appropriate services. If the lessons learned in this and other science support experiences are not applied by those involved with large information systems of the EOS (Earth Observing System) era, then the final data products produced by future science projects may not be robust or of high quality, thereby making the conduct of the project science less efficacious and reducing the value of these unique suites of data for future research.

Stormtime Magnetosphere-Ionosphere-Thermosphere Interactions and Dynamics

DTIC Science & Technology

2013-03-13

1 2. BACKGROUND ... BACKGROUND The studies described in this report were performed in support of ongoing and planned space weather programs in the areas of Space Situational...Ionosphere The purpose of this effort was to initiate on-going analysis of COSMIC -GPS measurements of total electron content (TEC) in the dayside

Exposure Modeling Tools and Databases for Consideration for Relevance to the Amended TSCA (ISES)

EPA Science Inventory

The Agency’s Office of Research and Development (ORD) has a number of ongoing exposure modeling tools and databases. These efforts are anticipated to be useful in supporting ongoing implementation of the amended Toxic Substances Control Act (TSCA). Under ORD’s Chemic...

The effect of semantic context on prospective memory performance.

PubMed

Thomas, Brandon J; McBride, Dawn M

2016-01-01

The current study provides evidence for spontaneous processing in prospective memory (PM) or memory for intentions. Discrepancy-plus-search is the spontaneous processing of PM cues via disruptions in processing fluency of ongoing task items. We tested whether this mechanism can be demonstrated in an ongoing rating task with a dominant semantic context. Ongoing task items were manipulated such that the PM cues were members of a semantic category (i.e., Body Parts) that was congruent or discrepant with the dominant semantic category in the ongoing task. Results showed that participants correctly responded to more PM cues when there was a category discrepancy between the PM cues and ongoing task items. Moreover, participants' identification of PM cues was accompanied by faster ongoing task reaction times when PM cues were discrepant with ongoing task items than when they were congruent. These results suggest that a discrepancy-plus-search process supports PM retrieval in certain contexts, and that some discrepancy-plus-search mechanisms may result from the violation of processing expectations within a semantic context.

CPD Aligned to Competency Standards to Support Quality Practice

PubMed Central

Nash, Rose; Thompson, Wendy; Stupans, Ieva; Lau, Esther T. L.; Santos, Jose Manuel Serrano; Brown, Natalie; Nissen, Lisa M.; Chalmers, Leanne

2017-01-01

As medication experts, pharmacists are key members of the patient’s healthcare team. Pharmacists must maintain their competence to practice to remain responsive to the increasingly complex healthcare sector. This paper seeks to determine how competence training for pharmacists may enhance quality in their professional development. Results of two separately administered surveys (2012 and 2013) were compared to examine the reported continued professional development (CPD) practices of Australian pharmacists. Examination of results from both studies enabled a focus on how the competency standards inform CPD practice. In the survey administered in 2012, 91% (n = 253/278) pharmacists reported that they knew their current registration requirements. However, in the survey administered in 2013, only 43% (n = 46/107) reported utilization of the National Competency Standards Framework for Pharmacists in Australia (NCS) to self-asses their practice as part of their annual re-registration requirements. Fewer, 23% (n = 25/107), used the NCS to plan their CPD. This may be symptomatic of poor familiarity with the NCS, uncertainty around undertaking self-directed learning as part of a structured learning plan and/or misunderstandings around what CPD should include. This is supported by thematic analysis of pharmacists’ social media comments. Initial and ongoing competence training to support meaningful CPD requires urgent attention in Australia. The competence (knowledge, skills and attributes) required to engage in meaningful CPD practice should be introduced and developed prior to entry into practice; other countries may find they are in a similar position. PMID:28970424

CPD Aligned to Competency Standards to Support Quality Practice.

PubMed

Nash, Rose; Thompson, Wendy; Stupans, Ieva; Lau, Esther T L; Santos, Jose Manuel Serrano; Brown, Natalie; Nissen, Lisa M; Chalmers, Leanne

2017-02-25

As medication experts, pharmacists are key members of the patient's healthcare team. Pharmacists must maintain their competence to practice to remain responsive to the increasingly complex healthcare sector. This paper seeks to determine how competence training for pharmacists may enhance quality in their professional development. Results of two separately administered surveys (2012 and 2013) were compared to examine the reported continued professional development (CPD) practices of Australian pharmacists. Examination of results from both studies enabled a focus on how the competency standards inform CPD practice.In the survey administered in 2012, 91% ( n = 253/278) pharmacists reported that they knew their current registration requirements. However, in the survey administered in 2013, only 43% ( n = 46/107) reported utilization of the National Competency Standards Framework for Pharmacists in Australia (NCS) to self-asses their practice as part of their annual re-registration requirements. Fewer, 23% ( n = 25/107), used the NCS to plan their CPD. This may be symptomatic of poor familiarity with the NCS, uncertainty around undertaking self-directed learning as part of a structured learning plan and/or misunderstandings around what CPD should include. This is supported by thematic analysis of pharmacists' social media comments. Initial and ongoing competence training to support meaningful CPD requires urgent attention in Australia. The competence (knowledge, skills and attributes) required to engage in meaningful CPD practice should be introduced and developed prior to entry into practice; other countries may find they are in a similar position.

Design and implementation of an interactive website to support long-term maintenance of weight loss.

PubMed

Stevens, Victor J; Funk, Kristine L; Brantley, Phillip J; Erlinger, Thomas P; Myers, Valerie H; Champagne, Catherine M; Bauck, Alan; Samuel-Hodge, Carmen D; Hollis, Jack F

2008-01-25

For most individuals, long-term maintenance of weight loss requires long-term, supportive intervention. Internet-based weight loss maintenance programs offer considerable potential for meeting this need. Careful design processes are required to maximize adherence and minimize attrition. This paper describes the development, implementation and use of a Web-based intervention program designed to help those who have recently lost weight sustain their weight loss over 1 year. The weight loss maintenance website was developed over a 1-year period by an interdisciplinary team of public health researchers, behavior change intervention experts, applications developers, and interface designers. Key interactive features of the final site include social support, self-monitoring, written guidelines for diet and physical activity, links to appropriate websites, supportive tools for behavior change, check-in accountability, tailored reinforcement messages, and problem solving and relapse prevention training. The weight loss maintenance program included a reminder system (automated email and telephone messages) that prompted participants to return to the website if they missed their check-in date. If there was no log-in response to the email and telephone automated prompts, a staff member called the participant. We tracked the proportion of participants with at least one log-in per month, and analyzed log-ins as a result of automated prompts. The mean age of the 348 participants enrolled in an ongoing randomized trial and assigned to use the website was 56 years; 63% were female, and 38% were African American. While weight loss data will not be available until mid-2008, website use remained high during the first year with over 80% of the participants still using the website during month 12. During the first 52 weeks, participants averaged 35 weeks with at least one log-in. Email and telephone prompts appear to be very effective at helping participants sustain ongoing website use. Developing interactive websites is expensive, complex, and time consuming. We found that extensive paper prototyping well in advance of programming and a versatile product manager who could work with project staff at all levels of detail were essential to keeping the development process efficient. clinicaltrials.gov NCT00054925.

Optimizing identification and management of COPD patients - reviewing the role of the community pharmacist.

PubMed

van der Molen, Thys; van Boven, Job F M; Maguire, Terence; Goyal, Pankaj; Altman, Pablo

2017-01-01

The aim of this paper was to propose key steps for community pharmacist integration into a patient care pathway for chronic obstructive pulmonary disease (COPD) management. A literature search was conducted to identify publications focusing on the role of the community pharmacist in identification and management of COPD. The literature search highlighted evidence supporting an important role for pharmacists at each of the four key steps in the patient care pathway for COPD management. Step 1 (primary prevention): pharmacists are ideally placed to provide information on disease awareness and risk prevention campaigns, and to encourage lifestyle interventions, including smoking cessation. Step 2 (early detection/case finding): pharmacists are often the first point of contact between the patient and the healthcare system and can therefore play an important role in the early identification of patients with COPD. Step 3 (management and ongoing support): pharmacists can assist patients by providing advice and education on dosage, inhaler technique, treatment expectations and the importance of adherence, and by supporting self-management, including recognition and treatment of COPD exacerbations. Step 4 (review and follow-up): pharmacists can play an important role in monitoring adherence and ongoing inhaler technique in patients with COPD. In summary, pharmacists are ideally positioned to play a vital role in all key stages of an integrated COPD patient care pathway from early disease detection to the support of management plans, including advice and counselling regarding medications, inhaler technique and treatment adherence. Areas requiring additional consideration include pharmacist training, increasing awareness of the pharmacist role, administration and reimbursement, and increasing physician-pharmacist collaboration. © 2016 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.

Surveying Supported Employment in Finland: A Follow-up

ERIC Educational Resources Information Center

Saloviita, Timo; Pirttimaa, Raija

2007-01-01

The longitudinal status of supported employment in Finland was examined via a 2003 nationwide survey sent to job coaches involved in supporting workers with intellectual and other disabilities. Sustained supported employment, defined as "paid work in integrated settings with ongoing supports that contained at least two on-site visits per…

People with COPD perceive ongoing, structured and socially supportive exercise opportunities to be important for maintaining an active lifestyle following pulmonary rehabilitation: a qualitative study.

PubMed

Hogg, Lauren; Grant, Amy; Garrod, Rachel; Fiddler, Helen

2012-01-01

What are the views and perceptions of people with chronic obstructive pulmonary disease (COPD) regarding maintaining an active lifestyle following a course of pulmonary rehabilitation? Qualitative study of two focus groups using a grounded theory approach. Sixteen people with COPD who had completed a course of pulmonary rehabilitation. Data from focus groups concurred and five main themes emerged: value of pulmonary rehabilitation, ongoing exercise, professional support, peer social support, and health status. Pulmonary rehabilitation was seen as facilitating greater participation in everyday activity by improving physical ability and confidence to manage breathlessness, and reducing fear about exertional activity. An exercise routine following rehabilitation was perceived as essential for maintaining activity, with participants voicing a need for ongoing, structured and supervised sessions to maintain new found abilities. The exercise facility presented a possible barrier to attendance due to its potential to provoke feelings of embarrassment or intimidation. Professional and peer support were identified as key elements; participants expressed a desire to exercise within a peer group combined with an opportunity for social interaction. Health status relating to COPD symptoms was also identified as negatively impacting on physical activity participation. Confidence or self-efficacy for physical activity emerged as a prominent factor within main themes. The opportunity for structured, ongoing exercise with peer and professional support, in a suitable venue, is perceived as important to people with COPD in facilitating a physically active lifestyle following pulmonary rehabilitation. This desire for such opportunities may be related to individuals' self-efficacy towards physical activity. Copyright © 2012 Australian Physiotherapy Association. Published by .. All rights reserved.

Automated Methodologies for the Design of Flow Diagrams for Development and Maintenance Activities

NASA Astrophysics Data System (ADS)

Shivanand M., Handigund; Shweta, Bhat

The Software Requirements Specification (SRS) of the organization is a text document prepared by strategic management incorporating the requirements of the organization. These requirements of ongoing business/ project development process involve the software tools, the hardware devices, the manual procedures, the application programs and the communication commands. These components are appropriately ordered for achieving the mission of the concerned process both in the project development and the ongoing business processes, in different flow diagrams viz. activity chart, workflow diagram, activity diagram, component diagram and deployment diagram. This paper proposes two generic, automatic methodologies for the design of various flow diagrams of (i) project development activities, (ii) ongoing business process. The methodologies also resolve the ensuing deadlocks in the flow diagrams and determine the critical paths for the activity chart. Though both methodologies are independent, each complements other in authenticating its correctness and completeness.

A Planetary Defense Gateway for Smart Discovery of relevant Information for Decision Support

NASA Technical Reports Server (NTRS)

Bambacus, Myra; Yang, Chaowei Phil; Leung, Ronald Y.; Barbee, Brent; Nuth, Joseph A.; Seery, Bernard; Jiang, Yongyao; Qin, Han; Li, Yun; Yu, Manzhu;

Estimating the number of adults with severe and persistent mental illness who have complex, multi-agency needs.

PubMed

Whiteford, Harvey; Buckingham, Bill; Harris, Meredith; Diminic, Sandra; Stockings, Emily; Degenhardt, Louisa

2017-08-01

A population health approach to mental health service planning requires estimates that align interventions with the needs of people with mental illness. The primary objective was to estimate the number of people in Australia living with severe and persistent mental illness who have complex, multi-agency needs. The secondary objective was to describe the possible service needs of individuals with severe mental illness. We disaggregated the estimated 12-month prevalence of adults with severe mental illness into needs-based sub-groups, using multiple data sources. Possible service needs of 1825 adults with psychotic disorders and 334 adults with severe past-year affective and/or anxiety disorders were described using data from the 2010 Survey of High Impact Psychosis and 2007 National Survey of Mental Health and Wellbeing, respectively. Using best available data, we estimated that 3.3% of adults experience a severe mental illness each year, of whom one-third (1.1% of adults) experience a persistent mental illness that requires ongoing services to address residual disability. Among those with severe and persistent mental illness, one-third of adults (0.4% or 59,000 adults in 2015) have complex needs requiring multi-agency support to maximise their health, housing, social participation and personal functioning. Survey of High Impact Psychosis data indicated that among adults with psychotic disorders, use of accommodation (40%), non-government (30%) services and receipt of income support (85%) services were common, as were possible needs for support with socialising, personal care and employment. National Survey of Mental Health and Wellbeing data indicated that among individuals with severe affective and anxiety disorders, receipt of income support (37%) was common (information on accommodation and non-government support services was not available), as were possible needs for financial management and employment support. Agreed indicators of complex, multi-agency needs are required to refine these estimates. Closer alignment of information collected about possible service needs across epidemiological surveys is needed.

EDOS operations concept and development approach

NASA Technical Reports Server (NTRS)

Knoble, G.; Garman, C.; Alcott, G.; Ramchandani, C.; Silvers, J.

1994-01-01

The Earth Observing System (EOS) Data and Operations System (EDOS) is being developed by the National Aeronautics and Space Administration (NASA) Goddard Space Flight Center (GSFC) for the capture, level zero processing, distribution, and backup archiving of high speed telemetry data received from EOS spacecraft. All data received will conform to the Consultative Committee for Space Data Standards (CCSDS) recommendations. The major EDOS goals are to: (1) minimize EOS program costs to implement and operate EDOS; (2) respond effectively to EOS growth requirements; and (3) maintain compatibility with existing and enhanced versions of NASA institutional systems required to support EOS spacecraft. In order to meet these goals, the following objectives have been defined for EDOS: (1) standardize EDOS interfaces to maximize utility for future requirements; (2) emphasize life-cycle cost (LCC) considerations (rather than procurement costs) in making design decisions and meeting reliability, maintainability, availability (RMA) and upgradability requirements; (3) implement data-driven operations to the maximum extent possible to minimize staffing requirements and to maximize system responsiveness; (4) provide a system capable of simultaneously supporting multiple spacecraft, each in different phases of their life-cycles; (5) provide for technology insertion features to accommodate growth and future LCC reductions during the operations phase; and (6) provide a system that is sufficiently robust to accommodate incremental performance upgrades while supporting operations. Operations concept working group meetings were facilitated to help develop the EDOS operations concept. This provided a cohesive concept that met with approval of responsible personnel from the start. This approach not only speeded up the development process by reducing review cycles, it also provided a medium for generating good ideas that were immediately molded into feasible concepts. The operations concept was then used as a basis for the EDOS specification. When it was felt that concept elements did not support detailed requirements, the facilitator process was used to resolve discrepancies or to add new concept elements to support the specification. This method provided an ongoing revisal of the operations concept and prevented large revisions at the end of the requirement analysis phase of system development.

Personalized use of ICT--from telemonitoring to ambient assisted living.

PubMed

Norgall, Thomas; Wichert, Reiner

2013-01-01

Individual availability of information and communications technology (ICT) has enabled "Personal Health" applications like the continuous ubiquitous telemonitoring of vital signs. The concept of Ambient Assisted Living (AAL) goes beyond health and care applications utilizing home automation technology for supporting individuals with specific needs, particularly enabling elderly to live in their accustomed home as long as possible. These users usually suffer from more than one disease and need compensation of several impairments. Most current AAL projects and products however provide insulated solutions addressing only a small selection of these user needs. For comprehensive dynamic system adaptation to changing user needs an open platform supporting interoperable components is required. While the industry-driven Continua Health Alliance developed a corresponding Personal Health ecosystem, the ongoing European project universAAL aims at a universal platform for both AAL and Personal Health applications.

Workplan for U.S. Geological Survey hydrologic data-collection and support activities on Fort Wainwright, Alaska, 1994-97

USGS Publications Warehouse

Claar, David V.; Lilly, Michael R.

1999-01-01

The U.S. Army Alaska is responsible for environmental activities on Fort Wainwright near Fairbanks, Alaska. In order to better meet the needs of environmental investigations, the Army requires geohydrologic information about the Fort Wainwright area. Since 1994, the U.S. Geological Survey has been working in cooperation with the U.S. Army Alaska and the U.S. Army Corps of Engineers to investigate the geohydrology of the Fort Wainwright area. The primary objectives of the study are to collect basic ground-water and surface-water data and to support ongoing environmental investigations by other agencies. This report is the workplan describing the technical methods used by the USGS to meet these objectives. It includes details on field procedures, data collection, and analyses of water samples.

Using online learning in a traditional face-to-face environment.

PubMed

Kozlowski, Dawn

2002-01-01

A model for designing online learning was developed and implemented in a Registered Nurse-to-Bachelor of Science in Nursing course using online and face-to-face methodologies. The combination of online and face-to-face learning modalities may help the student who is a novice Internet explorer or seasoned Web navigator by offering technological support as well as providing constant in-person feedback regarding course requirements. The face-to-face component facilitates a sense of community and peer support that sometimes is lacking in an entirely online course. During the 2 semesters this model was used, students expressed satisfaction with having the course facilitator/professor physically available for consultation and advisement. Evaluation of this online/on-site course is ongoing and uses computer-administered qualitative questionnaires, a facilitator-moderated focus group, and Likert-type course evaluations.

Internet Tomography in Support of Internet and Network Simulation and Emulation Modelling

NASA Astrophysics Data System (ADS)

Moloisane, A.; Ganchev, I.; O'Droma, M.

Internet performance measurement data extracted through Internet Tomography techniques and metrics and how it may be used to enhance the capacity of network simulation and emulation modelling is addressed in this paper. The advantages of network simulation and emulation as a means to aid design and develop the component networks, which make up the Internet and are fundamental to its ongoing evolution, are highlighted. The Internet's rapid growth has spurred development of new protocols and algorithms to meet changing operational requirements such as security, multicast delivery, mobile networking, policy management, and quality of service (QoS) support. Both the development and evaluation of these operational tools requires the answering of many design and operational questions. Creating the technical support required by network engineers and managers in their efforts to seek answers to these questions is in itself a major challenge. Within the Internet the number and range of services supported continues to grow exponentially, from legacy and client/server applications to VoIP, multimedia streaming services and interactive multimedia services. Services have their own distinctive requirements and idiosyncrasies. They respond differently to bandwidth limitations, latency and jitter problems. They generate different types of “conversations” between end-user terminals, back-end resources and middle-tier servers. To add to the complexity, each new or enhanced service introduced onto the network contends for available bandwidth with every other service. In an effort to ensure networking products and resources being designed and developed handling diverse conditions encountered in real Internet environments, network simulation and emulation modelling is a valuable tool, and becoming a critical element, in networking product and application design and development. The better these laboratory tools reflect real-world environment and conditions the more helpful to designers they will be.

The road to pharmacist prescribing in Alberta Health Services.

PubMed

Gray, Margaret; Mysak, Tania

2016-09-15

The implementation of policy within a health organization to support a new legislative and regulatory framework of pharmacist prescribing in the Canadian province of Alberta is described. The evolution of pharmacists' practice activities to encompass medication management through independent prescribing authority has occurred in many jurisdictions around the world. In 2007, Alberta pharmacists were granted the most progressive scope of practice in all of North America. Pursuant to a series of legislative and regulatory initiatives enacted since 2000, the provincial health authority, Alberta Health Services (AHS), has worked to (1) establish a policy framework that supports pharmacist prescribing, (2) provide opportunities for pharmacist prescribing in both inpatient and ambulatory care practice environments, and (3) provide motivation and resources for AHS pharmacists to acquire "additional prescribing authorization" (APA) that enables them to independently prescribe and manage patients' ongoing drug therapy. Pharmacists with APA currently are permitted to prescribe all medications requiring a prescription, with the exception of opiates and other controlled substances; efforts to expand pharmacist prescribing to include those medications are ongoing. Currently, nearly half of all AHS pharmacists have APA. The health authority plans to make APA a standard expectation for all clinical pharmacists working in collaborative practice settings. Opportunities provided to Alberta pharmacists by legislation have been embraced by the provincial health authority. The AHS leadership remains committed to ensuring that its pharmacists practice to the full extent of their scope of practice and actively encourages and supports them in their efforts to provide optimal patient care. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Working Memory in the Service of Executive Control Functions.

PubMed

Mansouri, Farshad A; Rosa, Marcello G P; Atapour, Nafiseh

2015-01-01

Working memory is a type of short-term memory which has a crucial cognitive function that supports ongoing and upcoming behaviors, allowing storage of information across delay periods. The content of this memory may typically include tangible information about features such as the shape, color or texture of an object, and its location and motion relative to the body, as well as phonological information. The neural correlate of working memory has been found in different brain areas that are involved in organizing perceptual or motor functions. In particular, neuronal activity in prefrontal areas encodes task-related information corresponding to working memory across delay periods, and lesions in the prefrontal cortex severely affect the ability to retain this type of memory. Recent studies have further expanded the scope and possible role of working memory by showing that information of a more abstract nature (including a behavior-guiding rule, or the occurrence of a conflict in information processing) can also be maintained in short-term memory, and used for adjusting the allocation of executive control in dynamic environments. It has also been shown that neuronal activity in the prefrontal cortex encodes and maintains information about such abstract entities. These findings suggest that the prefrontal cortex plays crucial roles in the organization of goal-directed behavior by supporting many different mnemonic processes, which maintain a wide range of information required for the executive control of ongoing and upcoming behaviors.

Ectopic lymphoid structures support ongoing production of class-switched autoantibodies in rheumatoid synovium.

PubMed

Humby, Frances; Bombardieri, Michele; Manzo, Antonio; Kelly, Stephen; Blades, Mark C; Kirkham, Bruce; Spencer, Jo; Pitzalis, Costantino

2009-01-13

Follicular structures resembling germinal centres (GCs) that are characterized by follicular dendritic cell (FDC) networks have long been recognized in chronically inflamed tissues in autoimmune diseases, including the synovium of rheumatoid arthritis (RA). However, it is debated whether these ectopic structures promote autoimmunity and chronic inflammation driving the production of pathogenic autoantibodies. Anti-citrullinated protein/peptide antibodies (ACPA) are highly specific markers of RA, predict a poor prognosis, and have been suggested to be pathogenic. Therefore, the main study objectives were to determine whether ectopic lymphoid structures in RA synovium: (i) express activation-induced cytidine deaminase (AID), the enzyme required for somatic hypermutation and class-switch recombination (CSR) of Ig genes; (ii) support ongoing CSR and ACPA production; and (iii) remain functional in a RA/severe combined immunodeficiency (SCID) chimera model devoid of new immune cell influx into the synovium. Using immunohistochemistry (IHC) and quantitative Taqman real-time PCR (QT-PCR) in synovial tissue from 55 patients with RA, we demonstrated that FDC+ structures invariably expressed AID with a distribution resembling secondary lymphoid organs. Further, AID+/CD21+ follicular structures were surrounded by ACPA+/CD138+ plasma cells, as demonstrated by immune reactivity to citrullinated fibrinogen. Moreover, we identified a novel subset of synovial AID+/CD20+ B cells outside GCs resembling interfollicular large B cells. In order to gain direct functional evidence that AID+ structures support CSR and in situ manufacturing of class-switched ACPA, 34 SCID mice were transplanted with RA synovium and humanely killed at 4 wk for harvesting of transplants and sera. Persistent expression of AID and Igamma-Cmu circular transcripts (identifying ongoing IgM-IgG class-switching) was observed in synovial grafts expressing FDCs/CD21L. Furthermore, synovial mRNA levels of AID were closely associated with circulating human IgG ACPA in mouse sera. Finally, the survival and proliferation of functional B cell niches was associated with persistent overexpression of genes regulating ectopic lymphoneogenesis. Our demonstration that FDC+ follicular units invariably express AID and are surrounded by ACPA-producing plasma cells provides strong evidence that ectopic lymphoid structures in the RA synovium are functional and support autoantibody production. This concept is further confirmed by evidence of sustained AID expression, B cell proliferation, ongoing CSR, and production of human IgG ACPA from GC+ synovial tissue transplanted into SCID mice, independently of new B cell influx from the systemic circulation. These data identify AID as a potential therapeutic target in RA and suggest that survival of functional synovial B cell niches may profoundly influence chronic inflammation, autoimmunity, and response to B cell-depleting therapies.

Towards a Community-Based Dementia Care Strategy: A Perspective from Quebec.

PubMed

Godard-Sebillotte, Claire; Vedel, Isabelle; Bergman, Howard

Morton-Chang et al. highlighted in their article the key strategic pillars of a community-based dementia care strategy: put "people first," support informal caregiving and enable "ground up" innovation and change. In our commentary, we draw upon our experience as authors of the Quebec Alzheimer Plan and evaluators of its implementation by the Quebec Ministry of Health and Social Services (MSSS). To us, a sustainable dementia care strategy entails a patient-centred approach, grounded in primary care, caring for persons with dementia at every stage of the disease. Implementation of such a strategy requires an ongoing effort to allow innovation adoption by clinicians and organizations.

Evolving prehospital, emergency department, and "inpatient" management models for geriatric emergencies.

PubMed

Carpenter, Christopher R; Platts-Mills, Timothy F

2013-02-01

Alternative management methods are essential to ensure high-quality and efficient emergency care for the growing number of geriatric adults worldwide. Protocols to support early condition-specific treatment of older adults with acute severe illness and injury are needed. Improved emergency department care for older adults will require providers to address the influence of other factors on the patient's health. This article describes recent and ongoing efforts to enhance the quality of emergency care for older adults using alternative management approaches spanning the spectrum from prehospital care, through the emergency department, and into evolving inpatient or outpatient processes of care. Copyright © 2013 Elsevier Inc. All rights reserved.

76 FR 63509 - Small Business Size Standards: Administrative and Support, Waste Management and Remediation Services

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-12

... Small Business Size Standards: Administrative and Support, Waste Management and Remediation Services... Standards: Administrative and Support, Waste Management and Remediation Services AGENCY: U.S. Small Business...) Sector 56, Administrative and Support, Waste Management and Remediation Services. As part of its ongoing...

The digital revolution in phenotyping

PubMed Central

Oellrich, Anika; Collier, Nigel; Groza, Tudor; Rebholz-Schuhmann, Dietrich; Shah, Nigam; Bodenreider, Olivier; Boland, Mary Regina; Georgiev, Ivo; Liu, Hongfang; Livingston, Kevin; Luna, Augustin; Mallon, Ann-Marie; Manda, Prashanti; Robinson, Peter N.; Rustici, Gabriella; Simon, Michelle; Wang, Liqin; Winnenburg, Rainer; Dumontier, Michel

2016-01-01

Phenotypes have gained increased notoriety in the clinical and biological domain owing to their application in numerous areas such as the discovery of disease genes and drug targets, phylogenetics and pharmacogenomics. Phenotypes, defined as observable characteristics of organisms, can be seen as one of the bridges that lead to a translation of experimental findings into clinical applications and thereby support ‘bench to bedside’ efforts. However, to build this translational bridge, a common and universal understanding of phenotypes is required that goes beyond domain-specific definitions. To achieve this ambitious goal, a digital revolution is ongoing that enables the encoding of data in computer-readable formats and the data storage in specialized repositories, ready for integration, enabling translational research. While phenome research is an ongoing endeavor, the true potential hidden in the currently available data still needs to be unlocked, offering exciting opportunities for the forthcoming years. Here, we provide insights into the state-of-the-art in digital phenotyping, by means of representing, acquiring and analyzing phenotype data. In addition, we provide visions of this field for future research work that could enable better applications of phenotype data. PMID:26420780

Water-Related Infrastructure in a Region of Post-Earthquake Haiti: High Levels of Fecal Contamination and Need for Ongoing Monitoring

PubMed Central

Widmer, Jocelyn M.; Weppelmann, Thomas A.; Alam, Meer T.; Morrissey, B. David; Redden, Edsel; Rashid, Mohammed H.; Diamond, Ulrica; Ali, Afsar; De Rochars, Madsen Beau; Blackburn, Jason K.; Johnson, Judith A.; Morris, J. Glenn

2014-01-01

We inventoried non-surface water sources in the Leogane and Gressier region of Haiti (approximately 270 km2) in 2012 and 2013 and screened water from 345 sites for fecal coliforms and Vibrio cholerae. An international organization/non-governmental organization responsible for construction could be identified for only 56% of water points evaluated. Sixteen percent of water points were non-functional at any given time; 37% had evidence of fecal contamination, with spatial clustering of contaminated sites. Among improved water sources (76% of sites), 24.6% had fecal coliforms versus 80.9% in unimproved sources. Fecal contamination levels increased significantly from 36% to 51% immediately after the passage of Tropical Storm Sandy in October of 2012, with a return to 34% contamination in March of 2013. Long-term sustainability of potable water delivery at a regional scale requires ongoing assessment of water quality, functionality, and development of community-based management schemes supported by a national plan for the management of potable water. PMID:25071005

Water-related infrastructure in a region of post-earthquake Haiti: high levels of fecal contamination and need for ongoing monitoring.

PubMed

Widmer, Jocelyn M; Weppelmann, Thomas A; Alam, Meer T; Morrissey, B David; Redden, Edsel; Rashid, Mohammed H; Diamond, Ulrica; Ali, Afsar; De Rochars, Madsen Beau; Blackburn, Jason K; Johnson, Judith A; Morris, J Glenn

2014-10-01

We inventoried non-surface water sources in the Leogane and Gressier region of Haiti (approximately 270 km(2)) in 2012 and 2013 and screened water from 345 sites for fecal coliforms and Vibrio cholerae. An international organization/non-governmental organization responsible for construction could be identified for only 56% of water points evaluated. Sixteen percent of water points were non-functional at any given time; 37% had evidence of fecal contamination, with spatial clustering of contaminated sites. Among improved water sources (76% of sites), 24.6% had fecal coliforms versus 80.9% in unimproved sources. Fecal contamination levels increased significantly from 36% to 51% immediately after the passage of Tropical Storm Sandy in October of 2012, with a return to 34% contamination in March of 2013. Long-term sustainability of potable water delivery at a regional scale requires ongoing assessment of water quality, functionality, and development of community-based management schemes supported by a national plan for the management of potable water. © The American Society of Tropical Medicine and Hygiene.

FETC/EPRI Biomass Cofiring Cooperative Agreement. Quarterly technical report, April 1-June 30, 1997

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hughes, E.; Tillman, D.

1997-12-01

The FETC/EPRI Biomass Cofiring Program has accelerated the pace of cofiring development by increasing the testing activities plus the support activities for interpreting test results. Past tests conducted and analyzed include the Allen Fossil Plant and Seward Generating Station programs. On-going tests include the Colbert Fossil Plant precommercial test program, the Greenidge Station commercialization program, and the Blount St. Station switchgrass program. Tests in the formative stages included the NIPSCO cofiring test at Michigan City Generating Station. Analytical activities included modeling and related support functions required to analyze the cofiring test results, and to place those results into context. Amongmore » these activities is the fuel availability study in the Pittsburgh, PA area. This study, conducted for Duquesne Light, supports their initial investigation into reburn technology using wood waste as a fuel. This Quarterly Report, covering the third quarter of the FETC/EPRI Biomass Cofiring Program, highlights the progress made on the 16 projects funded under this cooperative agreement.« less

Magnetic Measurements of Storage Ring Magnets for the APS Upgrade Project

DOE Office of Scientific and Technical Information (OSTI.GOV)

Doose, C.; Dejus, R.; Jaski, M.

2017-06-01

Extensive prototyping of storage ring magnets is ongoing at the Advanced Photon Source (APS) in support of the APS Multi-Bend Achromat (MBA) upgrade project (APS-U) [1]. As part of the R&D activities four quadrupole magnets with slightly different geometries and pole tip materials, and one sextupole magnet with vanadium permendur (VP) pole tips were designed, built and tested. Magnets were measured individually using a rotating coil and a Hall probe for detailed mapping of the magnetic field. Magnets were then assembled and aligned relative to each other on a steel support plate and concrete plinth using precision machined surfaces tomore » gain experience with the alignment method chosen for the APS-U storage ring magnets. The required alignment of magnets on a common support structure is 30 μm rms. Measurements of magnetic field quality, strength and magnet alignment after subjecting the magnets and assemblies to different tests are presented.« less

Left ventricular assist device exchange: the Toronto General Hospital experience.

PubMed

Tsubota, Hideki; Ribeiro, Roberto V P; Billia, Filio; Cusimano, Robert J; Yau, Terrence M; Badiwala, Mitesh V; Stansfield, William E; Rao, Vivek

2017-08-01

As support times for left ventricular assist devices (LVADs) become longer, several complications requiring device exchange may occur. To our knowledge, this is the first Canadian report regarding implantable LVAD exchange. We retrospectively reviewed the cases of consecutive, unique patients implanted with an LVAD between June 2006 and October 2015 at Toronto General Hospital. In total, 122 patients were impanted with an LVAD during the study period. Eight patients required LVAD exchange, and 1 patient had 2 replacements (9 of 122, 7.3%). There were 7 HeartMate II (HMII), 1 HVAD and 1 DuraHeart pumps exchanged. Two of these exchanges occurred early at the time of initial implant, whereas 7 occurred late (range 8-623 d). Six exchanges were made owing to pump thrombosis. Of the 3 exchanges made for other causes, 1 HMII exchange was owing to a driveline fracture, 1 DuraHeart patient had early inflow obstruction requiring exchange to HMII at the initial implant, and the third had a suspected inflow obstruction with no evidence of thrombosis at the time of the procedure. The mean support time before exchange was 225 days, and time from exchange to transplant, death or ongoing support was 245 days. Three patients were successfully bridged to transplant, and at the time of data collection 2 were supported awaiting transplant. Three patients died after a mean duration of 394.3 days (range 78-673 d) of support postreplacement. Four cases were successfully performed using a subcostal approach. Pump thrombosis is the most common cause for LVAD exchange, which can be performed with acceptable morbidity and mortality. The subcostal approach may be the preferred procedure for an HMII exchange when indicated.

Invited review: Experimental design, data reporting, and sharing in support of animal systems modeling research.

PubMed

McNamara, J P; Hanigan, M D; White, R R

2016-12-01

The National Animal Nutrition Program "National Research Support Project 9" supports efforts in livestock nutrition, including the National Research Council's committees on the nutrient requirements of animals. Our objective was to review the status of experimentation and data reporting in animal nutrition literature and to provide suggestions for the advancement of animal nutrition research and the ongoing improvement of field-applied nutrient requirement models. Improved data reporting consistency and completeness represent a substantial opportunity to improve nutrition-related mathematical models. We reviewed a body of nutrition research; recorded common phrases used to describe diets, animals, housing, and environmental conditions; and proposed equivalent numerical data that could be reported. With the increasing availability of online supplementary material sections in journals, we developed a comprehensive checklist of data that should be included in publications. To continue to improve our research effectiveness, studies utilizing multiple research methodologies to address complex systems and measure multiple variables will be necessary. From the current body of animal nutrition literature, we identified a series of opportunities to integrate research focuses (nutrition, reproduction and genetics) to advance the development of nutrient requirement models. From our survey of current experimentation and data reporting in animal nutrition, we identified 4 key opportunities to advance animal nutrition knowledge: (1) coordinated experiments should be designed to employ multiple research methodologies; (2) systems-oriented research approaches should be encouraged and supported; (3) publication guidelines should be updated to encourage and support sharing of more complete data sets; and (4) new experiments should be more rapidly integrated into our knowledge bases, research programs and practical applications. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

The U.S. Forest Service's analysis of cumulative effects to wildlife: A study of legal standards, current practice, and ongoing challenges on a National Forest

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schultz, Courtney A., E-mail: courtney.schultz@colostate.edu

Cumulative effects analysis (CEA) allows natural resource managers to understand the status of resources in historical context, learn from past management actions, and adapt future activities accordingly. U.S. federal agencies are required to complete CEA as part of environmental impact assessment under the National Environmental Policy Act (NEPA). Past research on CEA as part of NEPA has identified significant deficiencies in CEA practice, suggested methodologies for handling difficult aspects of CEA, and analyzed the rise in litigation over CEA in U.S. courts. This article provides a review of the literature and legal standards related to CEA as it is donemore » under NEPA and then examines current practice on a U.S. National Forest, utilizing qualitative methods in order to provide a detailed understanding of current approaches to CEA. Research objectives were to understand current practice, investigate ongoing challenges, and identify impediments to improvement. Methods included a systematic review of a set of NEPA documents and semi-structured interviews with practitioners, scientists, and members of the public. Findings indicate that the primary challenges associated with CEA include: issues of both geographic and temporal scale of analysis, confusion over the purpose of the requirement, the lack of monitoring data, and problems coordinating and disseminating data. Improved monitoring strategies and programmatic analyses could support improved CEA practice.« less

Orion Entry Flight Control Stability and Performance

NASA Technical Reports Server (NTRS)

Strahan, Alan L.; Loe, Greg R.; Seiler, Pete

2007-01-01

The Orion Spacecraft will be required to perform entry and landing functions for both Low Earth Orbit (LEO) and Lunar return missions, utilizing only the Command Module (CM) with its unique systems and GN&C design. This paper presents the current CM Flight Control System (FCS) design to support entry and landing, with a focus on analyses that have supported its development to date. The CM FCS will have to provide for spacecraft stability and control while following guidance or manual commands during exo-atmospheric flight, after Service Module separation, translational powered flight required of the CM, atmospheric flight supporting both direct entry and skip trajectories down to drogue chute deploy, and during roll attitude reorientation just prior to touchdown. Various studies and analyses have been performed or are on-going supporting an overall FCS design with reasonably sized Reaction Control System (RCS) jets, that minimizes fuel usage, that provides appropriate command following but with reasonable stability and control margin. Results from these efforts to date are included, with particular attention on design issues that have emerged, such as the struggle to accommodate sub-sonic pitch and yaw control without using excessively large jets that could have a detrimental impact on vehicle weight. Apollo, with a similar shape, struggled with this issue as well. Outstanding CM FCS related design and analysis issues, planned for future effort, are also briefly be discussed.

Supporting Primary Care Practices in Building Capacity to Use Health Information Data

PubMed Central

Fernald, Douglas; Wearner, Robyn; Dickinson, W. Perry

2014-01-01

Introduction: Our objective was to describe essential support resources and strategies in order to advance the pace and scope of the use of health information technology (HIT) data. Background and Context: Primary data were collected between January 2011 and October 2012. The primary study population comprised 51 primary care practices enrolled in the Colorado Beacon Consortium in western Colorado. Methods: We used qualitative methods embedded in a mixed-method evaluation: monthly narrative reports from practices; interviews with providers and staff; and focused, group discussions with quality improvement (QI) advisors and staff from the Health Information Technology Regional Extension Center. Findings: Practices valued effective support strategies to assist with using HIT, including the following: translating rules and regulations into individual practice settings; facilitating peer-to-peer connections; providing processes and tools for practice improvement; maintaining accountability and momentum; and providing local electronic health record (EHR) technical expertise. Benefits of support included improved quality measures, operational improvements, increased provider and staff engagement, and deeper understanding of EHR data. Discussion: The findings affirm the utility of practice facilitation for HIT-focused aims with personalized attention and cross-fertilization among practices for improvements. Facilitation to sustain ongoing improvements and prepare for future HIT-intensive improvement activities was highly valued. In addition to the general practice facilitator, an EHR technical expert was critical to improving practice capacity to use electronic clinical data. Collaborative learning expands the pool of mentors and teachers, who can further translate their own lessons into practical advice for their peers, yielding the emergence of a stronger sense of community among the practices. Conclusions: Using HIT more effectively in primary care will require sustained, focused efforts by practices as regulations, incentives and HIT evolve. Ongoing support for community-based practice facilitators; collaborative learning; and local, personalized EHR advisors will help practices care for patients while more effectively deploying HIT to improve care. PMID:25848621

A supported employment linkage intervention for people with schizophrenia who want a chance to work.

PubMed

Solar, Ann

2014-06-01

Investigate feasibility and development of a linkage intervention to the evidence-based Individual Placement and Support (IPS) approach to supported employment (SE) for patients with schizophrenia on a mental health unit who want to work in competitive employment. Literature review about the evidence-based IPS approach to SE in schizophrenia and why it might not be implemented in mental health services. Analysis of 10 adult mental health unit multidisciplinary staff interviews for categories in the literature review of IPS implementation barriers and whether these barriers could be overcome. There was lack of full staff knowledge of the IPS approach to SE. However, all staff knew respect for patient choice was paramount, community employment programs existed for the disabled, an outreach linkage process to such a program and ongoing support for people with schizophrenia would be required. There was staff ambivalence about SE for patients with schizophrenia. Despite staff ambivalence about SE for people with schizophrenia there was still enough staff knowledge and openness to shape an IPS linkage intervention from a staff perspective. © The Royal Australian and New Zealand College of Psychiatrists 2014.

A narrative review of mental health support for people during transition from incarceration to community: the grass can be greener on the other side of the fence.

PubMed

Smith-Merry, Jennifer; Mellifont, Damian; McKenzie, Kirsty; Clenaghan, Paul

2018-04-28

Despite significant need for mental health services targeting the requirements of inmates transitioning into the community there is little research about successful recovery-oriented or person-centred transition programs. This systematic narrative review brings together existing evidence to inform policymakers and practitioners about current practice in transition support, and barriers and facilitators of effective practice. We carried out a systematic narrative review of recovery-oriented or person-centred mental health support programs supporting transition from incarceration to the community. Results were obtained from a systematic search of Medline, PubMed and Scopus databases. We found 23 papers which met the paper inclusion criteria along with four other papers which were identified incidentally. Identified barriers to the implementation of effective transition support programs are: administrative problems leading to ineffective in-reach into correctional facilities or untimely support, lack of support for immediate needs meaning that inmates deprioritise their mental health needs, a lack of ongoing program resources and poor communication between correctional facilities and mental health services. Enablers for transition reflect the inverse of these barriers, alongside other successful strategies including medical home models, regionalised programs, programs which target connections with primary care, nurse-led patient-centred health programs and peer support initiatives.

Two decades of nation-wide community-based stroke support - The Singapore National Stroke Association.

PubMed

Venketasubramanian, Narayanaswamy; Yin, Ann; Lee, Lay B; De Silva, Deidre A

2017-04-01

The Singapore National Stroke Association, registered in 1996, offers support and information to stroke survivors and caregivers, and aims to raise public stroke awareness. In the last 20 years, we have developed programs to equip stroke survivors and caregivers with knowledge, life skills, comfort, and opportunities for socialization and reintegration. We have on-going public education and advocacy initiatives. Obtaining funding, member recruitment, volunteer retention, and leadership renewal are on-going challenges. Singapore National Stroke Association will continue to strive for the betterment of stroke survivors, their caregivers, and the public.

Implementation of evidence-based patient navigation programs.

PubMed

Freund, Karen M

2017-02-01

Patient navigation refers to a direct patient care role that links patients with clinical providers and their support system and provides individualized support during cancer care, ensuring that patients have access to the knowledge and resources necessary to complete recommended treatment. While most reports have studied the role of patient navigators during the cancer screening or diagnostic process, emerging evidence indicates the benefits of patient navigation during active cancer treatment. Reports in the literature are conflicting on the impact of patient navigation during cancer care and on the benefits to timely or quality care in all populations. Recent sub-analyses of the Patient Navigation Research Program data demonstrated specifically the benefits of targeting patient navigation to the most vulnerable populations, including those with low educational attainment, low income and unstable housing, less social support, multiple comorbidities, and minority race/ethnicity. The implications of the Patient Navigation Research Program are that this resource is best utilized when directed to support the care of patients at locations with known challenges to timely care and for specific patients with risk factors for delays in care, including comorbidities, low educational attainment and low income. Implementation of patient navigation programs requires the following processes: needs assessment, selection of a navigator to meet the community and care needs, supervision and integration of the navigator into clinical processes, and systems support to facilitate the identification and tracking of those patients requiring patient navigation. There is a need for ongoing research on methods to fund and sustain patient navigation programs.

An Action Research Approach to Supporting Elite Student-Athletes in Higher Education

ERIC Educational Resources Information Center

McKenna, Jim; Dunstan-Lewis, Nicky

2004-01-01

Support for elite student-athletes was explored within a single English university using Stringer's (1996) Look, Think, Act model of action research. Entry to the ongoing support programme is competitive and participation is voluntary, with sessions delivered every second week after lectures. Based on supporting documentation, interviews, focus…

Quality user support: Supporting quality users

DOE Office of Scientific and Technical Information (OSTI.GOV)

Woolley, T.C.

1994-12-31

During the past decade, fundamental changes have occurred in technical computing in the oil industry. Technical computing systems have moved from local, fragmented quantity, to global, integrated, quality. The compute power available to the average geoscientist at his desktop has grown exponentially. Technical computing applications have increased in integration and complexity. At the same time, there has been a significant change in the work force due to the pressures of restructuring, and the increased focus on international opportunities. The profile of the user of technical computing resources has changed. Users are generally more mature, knowledgeable, and team oriented than theirmore » predecessors. In the 1990s, computer literacy is a requirement. This paper describes the steps taken by Oryx Energy Company to address the problems and opportunities created by the explosive growth in computing power and needs, coupled with the contraction of the business. A successful user support strategy will be described. Characteristics of the program include: (1) Client driven support; (2) Empowerment of highly skilled professionals to fill the support role; (3) Routine and ongoing modification to the support plan; (4) Utilization of the support assignment to create highly trained advocates on the line; (5) Integration of the support role to the reservoir management team. Results of the plan include a highly trained work force, stakeholder teams that include support personnel, and global support from a centralized support organization.« less

20 CFR 653.108 - State agency self-monitoring.

Code of Federal Regulations, 2010 CFR

2010-04-01

... compliance with JS regulations in serving MSFWs on an ongoing basis. The State Administrator shall have... Advocate shall: (1) Conduct an ongoing review of the delivery of services and protections afforded by JS... required reports, management information, the JS complaint system or otherwise are reviewed as soon as...

77 FR 72691 - Small Business Size Standards: Administrative and Support, Waste Management and Remediation Services

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-06

...: Administrative and Support, Waste Management and Remediation Services AGENCY: U.S. Small Business Administration..., Administrative and Support, Waste Management and Remediation Services. As part of its ongoing comprehensive... size standard for Environmental Remediation Services, an ``exception'' under NAICS 562910, Remediation...

Chemistry, manufacturing and control (CMC) and clinical trial technical support for influenza vaccine manufacturers.

PubMed

Wahid, Rahnuma; Holt, Renee; Hjorth, Richard; Berlanda Scorza, Francesco

2016-10-26

With the support of the Biomedical Advanced Research and Development Authority (BARDA) of the US Department of Health and Human Services, PATH has contributed to the World Health Organization's (WHO's) Global Action Plan for Influenza Vaccines (GAP) by providing technical and clinical assistance to several developing country vaccine manufacturers (DCVMs). GAP builds regionally based independent and sustainable influenza vaccine production capacity to mitigate the overall global shortage of influenza vaccines. The program also ensures adequate influenza vaccine manufacturing capacity in the event of an influenza pandemic. Since 2009, PATH has worked closely with two DCVMs in Vietnam: the Institute of Vaccines and Medical Biologicals (IVAC) and VABIOTECH. Beginning in 2013, PATH also began working with Torlak Institute in Serbia; Instituto Butantan in Brazil; Serum Institute of India Private Ltd. in India; and Changchun BCHT Biotechnology Co. (BCHT) in China. The DCVMs supported under the GAP program all had existing influenza vaccine manufacturing capability and required technical support from PATH to improve vaccine yield, process efficiency, and product formulation. PATH has provided customized technical support for the manufacturing process to each DCVM based on their respective requirements. Additionally, PATH, working with BARDA and WHO, supported several DCVMs in the clinical development of influenza vaccine candidates progressing toward national licensure or WHO prequalification. As a result of the activities outlined in this review, several companies were able to make excellent progress in developing state-of-the-art manufacturing processes and completing early phase clinical trials. Licensure trials are currently ongoing or planned for several DCVMs. Copyright © 2016 Elsevier Ltd. All rights reserved.

Development of a magnetic fluid shaft seal for an axial-flow blood pump.

PubMed

Sekine, Kazumitsu; Mitamura, Yoshinori; Murabayashi, Shun; Nishimura, Ikuya; Yozu, Ryouhei; Kim, Dong-Wook

2003-10-01

A rotating impeller in a rotary blood pump requires a supporting system in blood, such as a pivot bearing or magnetic suspension. To solve potential problems such as abrasive wear and complexity of a supporting system, a magnetic fluid seal was developed for use in an axial-flow blood pump. Sealing pressures at motor speeds of up to 8,000 rpm were measured with the seal immersed in water or bovine blood. The sealing pressure was about 200 mm Hg in water and blood. The calculated theoretical sealing pressure was about 230 mm Hg. The seal remained perfect for 743 days in a static condition and for 180+ days (ongoing test) at a motor speed of 7,000 rpm. Results of measurement of cell growth activity indicated that the magnetic fluid has no negative cytological effects. The specially designed magnetic fluid shaft seal is useful for an axial-flow blood pump.

Health care of youth aging out of foster care.

PubMed

2012-12-01

Youth transitioning out of foster care face significant medical and mental health care needs. Unfortunately, these youth rarely receive the services they need because of lack of health insurance. Through many policies and programs, the federal government has taken steps to support older youth in foster care and those aging out. The Fostering Connections to Success and Increasing Adoptions Act of 2008 (Pub L No. 110-354) requires states to work with youth to develop a transition plan that addresses issues such as health insurance. In addition, beginning in 2014, the Patient Protection and Affordable Care Act of 2010 (Pub L No. 111-148) makes youth aging out of foster care eligible for Medicaid coverage until age 26 years, regardless of income. Pediatricians can support youth aging out of foster care by working collaboratively with the child welfare agency in their state to ensure that the ongoing health needs of transitioning youth are met.

Application of the Disruption Predictor Feature Developer to developing a machine-portable disruption predictor

NASA Astrophysics Data System (ADS)

Parsons, Matthew; Tang, William; Feibush, Eliot

2016-10-01

Plasma disruptions pose a major threat to the operation of tokamaks which confine a large amount of stored energy. In order to effectively mitigate this damage it is necessary to predict an oncoming disruption with sufficient warning time to take mitigative action. Machine learning approaches to this problem have shown promise but require further developments to address (1) the need for machine-portable predictors and (2) the availability of multi-dimensional signal inputs. Here we demonstrate progress in these two areas by applying the Disruption Predictor Feature Developer to data from JET and NSTX, and discuss topics of focus for ongoing work in support of ITER. The author is also supported under the Fulbright U.S. Student Program as a graduate student in the department of Nuclear, Plasma and Radiological Engineering at the University of Illinois at Urbana-Champaign.

Design of a Multi-mode Flight Deck Decision Support System for Airborne Conflict Management

NASA Technical Reports Server (NTRS)

Barhydt, Richard; Krishnamurthy, Karthik

2004-01-01

NASA Langley has developed a multi-mode decision support system for pilots operating in a Distributed Air-Ground Traffic Management (DAG-TM) environment. An Autonomous Operations Planner (AOP) assists pilots in performing separation assurance functions, including conflict detection, prevention, and resolution. Ongoing AOP design has been based on a comprehensive human factors analysis and evaluation results from previous human-in-the-loop experiments with airline pilot test subjects. AOP considers complex flight mode interactions and provides flight guidance to pilots consistent with the current aircraft control state. Pilots communicate goals to AOP by setting system preferences and actively probing potential trajectories for conflicts. To minimize training requirements and improve operational use, AOP design leverages existing alerting philosophies, displays, and crew interfaces common on commercial aircraft. Future work will consider trajectory prediction uncertainties, integration with the TCAS collision avoidance system, and will incorporate enhancements based on an upcoming air-ground coordination experiment.

The development of a multi-target compiler-writing system for flight software development

NASA Technical Reports Server (NTRS)

Feyock, S.; Donegan, M. K.

1977-01-01

A wide variety of systems designed to assist the user in the task of writing compilers has been developed. A survey of these systems reveals that none is entirely appropriate to the purposes of the MUST project, which involves the compilation of one or at most a small set of higher-order languages to a wide variety of target machines offering little or no software support. This requirement dictates that any compiler writing system employed must provide maximal support in the areas of semantics specification and code generation, the areas in which existing compiler writing systems as well as theoretical underpinnings are weakest. This paper describes an ongoing research and development effort to create a compiler writing system which will overcome these difficulties, thus providing a software system which makes possible the fast, trouble-free creation of reliable compilers for a wide variety of target computers.

Matrix control of pancreatic cancer: New insights into fibronectin signaling.

PubMed

Topalovski, Mary; Brekken, Rolf A

2016-10-10

Pancreatic ductal adenocarcinoma (PDA) is a highly metastatic disease that resists most current therapies. A defining characteristic of PDA is an intense fibrotic response that promotes tumor cell invasion and chemoresistance. Efforts to understand the complex relationship between the tumor and its extracellular network and to therapeutically perturb tumor-stroma interactions are ongoing. Fibronectin (FN), a provisional matrix protein abundant in PDA stroma but not normal tissues, supports metastatic spread and chemoresistance of this deadly disease. FN also supports angiogenesis, which is required for even hypovascular tumors such as PDA to develop and progress. Targeting components of the tumor stroma, such as FN, can effectively reduce tumor growth and spread while also enhancing delivery of chemotherapy. Here, we review the molecular mechanisms by which FN drives angiogenesis, metastasis and chemoresistance in PDA. In light of these new findings, we also discuss therapeutic strategies to inhibit FN signaling. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

ATTDES: An Expert System for Satellite Attitude Determination and Control. 2

NASA Technical Reports Server (NTRS)

Mackison, Donald L.; Gifford, Kevin

1996-01-01

The design, analysis, and flight operations of satellite attitude determintion and attitude control systems require extensive mathematical formulations, optimization studies, and computer simulation. This is best done by an analyst with extensive education and experience. The development of programs such as ATTDES permit the use of advanced techniques by those with less experience. Typical tasks include the mission analysis to select stabilization and damping schemes, attitude determination sensors and algorithms, and control system designs to meet program requirements. ATTDES is a system that includes all of these activities, including high fidelity orbit environment models that can be used for preliminary analysis, parameter selection, stabilization schemes, the development of estimators covariance analyses, and optimization, and can support ongoing orbit activities. The modification of existing simulations to model new configurations for these purposes can be an expensive, time consuming activity that becomes a pacing item in the development and operation of such new systems. The use of an integrated tool such as ATTDES significantly reduces the effort and time required for these tasks.

Retooling Institutional Support Infrastructure for Clinical Research

PubMed Central

Snyder, Denise C.; Brouwer, Rebecca N.; Ennis, Cory L.; Spangler, Lindsey L.; Ainsworth, Terry L.; Budinger, Susan; Mullen, Catherine; Hawley, Jeffrey; Uhlenbrauck, Gina; Stacy, Mark

2016-01-01

Clinical research activities at academic medical centers are challenging to oversee. Without effective research administration, a continually evolving set of regulatory and institutional requirements can detract investigator and study team attention away from a focus on scientific gain, study conduct, and patient safety. However, even when the need for research administration is recognized, there can be struggles over what form it should take. Central research administration may be viewed negatively, with individual groups preferring to maintain autonomy over processes. Conversely, a proliferation of individualized approaches across an institution can create inefficiencies or invite risk. This article describes experiences establishing a unified research support office at the Duke University School of Medicine based on a framework of customer support. The Duke Office of Clinical Research was formed in 2012 with a vision that research administration at academic medical centers should help clinical investigators navigate the complex research environment and operationalize research ideas. The office provides an array of services that have received high satisfaction ratings. The authors describe the ongoing culture change necessary for success of the unified research support office. Lessons learned from implementation of the Duke Office of Clinical Research may serve as a model for other institutions undergoing a transition to unified research support. PMID:27125563

Diabetes self-management among Arab Americans: patient and provider perspectives.

PubMed

Fritz, Heather; DiZazzo-Miller, Rosanne; Bertran, Elizabeth A; Pociask, Fredrick D; Tarakji, Sandra; Arnetz, Judith; Lysack, Catherine L; Jaber, Linda A

2016-08-31

Arab Americans have a high burden of diabetes and poor outcomes compared to the general U.S. Diabetes self-management (DSM) requires a partnership between patients and providers that fosters mutual understanding and shared decision-making. Cultural factors influence this process; however, little is known regarding the cultural impact on DSM or if perceptions differ between patients and providers. Qualitative content analysis was used to analyze five focus groups-two groups with Arab American providers (n = 8) and three groups with adult Arab Americans with diabetes (n = 23). Focus groups examined patient and provider perspectives on the meaning of DSM and cultural barriers and facilitators among Arab American patients. Four distinct themes included limited resources for DSM education and support, stigma as a barrier to ongoing support, family support as an opportunity and challenge, and Arab American patient-provider relationships. Findings indicate several domains should be considered for clinical practice including a need to develop linguistically and culturally reliant educational materials and relevant supports for use in the Arab American population. Findings highlight differing views among providers and patients on the familial role in supporting DSM efforts and why some patients feel dissatisfied with clinical encounters.

Assessing the potential for an ongoing arms race within and between the sexes: selection and heritable variation.

PubMed

Friberg, Urban; Lew, Timothy A; Byrne, Phillip G; Rice, William R

2005-07-01

In promiscuous species, sexual selection generates two opposing male traits: offense (acquiring new mates and supplanting stored sperm) and defense (enforcing fidelity on one's mates and preventing sperm displacement when this fails). Coevolution between these traits requires both additive genetic variation and associated natural selection. Previous work with Drosophila melanogaster found autosomal genetic variation for these traits among inbred lines from a mixture of populations, but only nonheritable genetic variation was found within a single outbred population. These results do not support ongoing antagonistic coevolution between offense and defense, nor between either of these male traits and female reproductive characters. Here we use a new method (hemiclonal analysis) to study genomewide genetic variation in a large outbred laboratory population of D. melanogaster. Hemiclonal analysis estimates the additive genetic variation among random, genomewide haplotypes taken from a large, outbred, locally adapted laboratory population and determines the direction of the selection gradient on this variation. In contrast to earlier studies, we found low but biologically significant heritable variation for defensive and offensive offspring production as well as all their components (P1, fidelity, P2, and remating). Genetic correlations between these traits were substantially different from those reported for inbred lines. A positive genetic correlation was found between defense and offense, demonstrating that some shared genes influence both traits. In addition to this common variation, evidence for unique genetic variation for each trait was also found, supporting an ongoing coevolutionary arms race between defense and offense. Reproductive conflict between males can strongly influence female fitness. Correspondingly, we found genetic variation in both defense and offense that affected female fitness. No evidence was found for intersexual conflict in the context of male defense, but we found substantial intersexual conflict in the context of male offensive sperm competitive ability. These results indicate that conflict between competing males also promotes an associated arms race between the sexes.

‘It's trying to manage the work’: a qualitative evaluation of recruitment processes within a UK multicentre trial

PubMed Central

Skea, Zoë Christina; Treweek, Shaun; Gillies, Katie

2017-01-01

Objectives To explore trial site staff's perceptions regarding barriers and facilitators to local recruitment. Design Qualitative semi-structured interviews with a range of trial site staff from four trial sites in the UK. Interviews were analysed thematically to identify common themes across sites, barriers that could be addressed and facilitators that could be shared with other sites. Participants 11 members of staff from four trial sites: clinical grant Co-applicant (n=1); Principal Investigators (n=3); Consultant Urologist (n=1); Research Nurses (n=5); Research Assistant (n=1). Setting Embedded within an ongoing randomised controlled trial (the TISU trial). TISU is a UK multicentre trial comparing therapeutic interventions for ureteric stones. Results Our study draws attention to the initial and ongoing burden of trial work that is involved throughout the duration of a clinical trial. In terms of building and sustaining a research culture, trial staff described the ongoing work of engagement that was required to ensure that clinical staff were both educated and motivated to help with the process of identifying and screening potential participants. Having adequate and sufficient organisational and staffing resources was highlighted as being a necessary prerequisite to successful recruitment both in terms of accessing potentially eligible patients and being able to maximise recruitment after patient identification. The nature of the research study design can also potentially generate challenging communicative work for recruiting staff which can prove particularly problematic. Conclusions Our paper adds to existing research highlighting the importance of the hidden and complex work that is involved in clinical trial recruitment. Those designing and supporting the operationalisation of clinical trials must recognise and support the mitigation of this ‘work’. While much of the work is likely to be contextually sensitive at the level of local sites and for individual trials, some aspects are ubiquitous issues for delivery of trials more generally. Trial registration number ISRCTN No 92289221; Pre-results. PMID:28801422

Factors associated with the effectiveness of continuing education in long-term care.

PubMed

Stolee, Paul; Esbaugh, Jacquelin; Aylward, Sandra; Cathers, Tamzin; Harvey, David P; Hillier, Loretta M; Keat, Nancy; Feightner, John W

2005-06-01

This article examines factors within the long-term-care work environment that impact the effectiveness of continuing education. In Study 1, focus group interviews were conducted with staff and management from urban and rural long-term-care facilities in southwestern Ontario to identify their perceptions of the workplace factors that affect transfer of learning into practice. Thirty-five people were interviewed across six focus groups. In Study 2, a Delphi technique was used to refine our list of factors. Consensus was achieved in two survey rounds involving 30 and 27 participants, respectively. Management support was identified as the most important factor impacting the effectiveness of continuing education. Other factors included resources (staff, funding, space) and the need for ongoing expert support. Organizational support is necessary for continuing education programs to be effective and ongoing expert support is needed to enable and reinforce learning.

Using Facebook to Support Novice Teachers

ERIC Educational Resources Information Center

Staudt, Denise; St. Clair, Norman; Martinez, Elda E.

2013-01-01

Providing quality support for novice teachers as they enter the profession has been an ongoing concern of educator preparation programs. This article describes the efforts of one teacher preparation program in addressing this matter by utilizing Facebook[R] to provide sustained support and professional development for its beginning teachers. We…

System considerations favoring rotary artificial hearts with blood-immersed bearings.

PubMed

Jarvik, R K

1995-07-01

Hydrodynamic blood pumps provide such advantages as not requiring an air vent or compliance chamber as well as a great reduction in mechanical complexity with the potential for very long durability. The detailed design of their bearings is emerging as the single most important determinant of long-term success. Three categories of bearings include remote force, such as magnetic suspension; blood-isolated, which require a shaft seal; and blood-immersed using either mechanical or hydrodynamic support. Blood-immersed bearings permit maximum simplification and miniaturization of the entire system, require no flush fluid, and require no electronics as with magnetic suspension. The Jarvik 2000 heart represents an example of their potential. The intraventricular titanium pump (25 mm diameter, 25 cc, 85 g), uses blood flow through the motor air gap with blood-immersed bearings. The longest in vitro bearing durability test is ongoing at 20,000,000,000 revolutions with minimal wear (3 years at 15,000 rpm). In vivo results include 5-month calf survival, no thromboembolism, plasma Hb 2-5 mg%, and power under 10 W.

NASA Integrated Vehicle Health Management (NIVHM) A New Simulation Architecture. Part I; An Investigation

NASA Technical Reports Server (NTRS)

Sheppard, Gene

2005-01-01

The overall objective of this research is to explore the development of a new architecture for simulating a vehicle health monitoring system in support of NASA s on-going Integrated Vehicle Health Monitoring (IVHM) initiative. As discussed in NASA MSFC s IVHM workshop on June 29-July 1, 2004, a large number of sensors will be required for a robust IVHM system. The current simulation architecture is incapable of simulating the large number of sensors required for IVHM. Processing the data from the sensors into a format that a human operator can understand and assimilate in a timely manner will require a paradigm shift. Data from a single sensor is, at best, suspect and in order to overcome this deficiency, redundancy will be required for tomorrow s sensors. The sensor technology of tomorrow will allow for the placement of thousands of sensors per square inch. The major obstacle to overcome will then be how we can mitigate the torrent of data from raw sensor data to useful information to computer assisted decisionmaking.

Evaluation of a medication order writing standards policy in a regional health authority.

PubMed

Raymond, Colette B; Sproll, Barbara; Coates, Jan; Woloschuk, Donna M M

2013-09-01

The Winnipeg Regional Health Authority (WRHA) implemented a medication order writing standards (MOWS) policy (including banned abbreviations) to improve patient safety. Widespread educational campaigns and direct prescriber feedback were implemented. We audited orders within the WRHA from 2005 to 2009 and surveyed all WRHA staff in 2011 about the policy and suggestions for improving education and compliance. Overall, orders containing banned abbreviations, acronyms or symbols numbered 2261/8565 (26.4%) preimplementation. After WRHA-wide didactic education, the proportion declined to 1358/5461 (24.9%) (p = 0.043) and then, with targeted prescriber feedback, to 1186/6198 (19.1%) (p < 0.0001). A survey of 723 employees showed frequent violations of the MOWS, despite widespread knowledge of the policy. Respondents supported ongoing efforts to enforce the policy within the WRHA. Nonprescribers were significantly more likely than prescribers to agree with statements regarding enhancing compliance by defining prescriber/transcriber responsibilities and placing sanctions on noncompliant prescribers. Education, raising general awareness and targeted feedback to prescribers alone are insufficient to ensure compliance with MOWS policies. WRHA staff supported ongoing communication, improved tools such as compliant preprinted orders and reporting and feedback about medication incidents. A surprising number of respondents supported placing sanctions on noncompliant prescribers. Serial audits and targeted interventions such as direct prescriber feedback improve prescription quality in inpatient hospital settings. Education plus direct prescriber feedback had a greater impact than education alone on improving compliance with a MOWS policy. Future efforts at the WRHA to improve compliance will require an expanded focus on incentives, resources and development of action plans that involve all affected staff, not just prescribers. Plans include continued advertising, MOWS summaries in all charts, all-staff education, reminders and exploration of sustainable interventions for targeted feedback for prescribers.

Autonomous flight and remote site landing guidance research for helicopters

NASA Technical Reports Server (NTRS)

Denton, R. V.; Pecklesma, N. J.; Smith, F. W.

1987-01-01

Automated low-altitude flight and landing in remote areas within a civilian environment are investigated, where initial cost, ongoing maintenance costs, and system productivity are important considerations. An approach has been taken which has: (1) utilized those technologies developed for military applications which are directly transferable to a civilian mission; (2) exploited and developed technology areas where new methods or concepts are required; and (3) undertaken research with the potential to lead to innovative methods or concepts required to achieve a manual and fully automatic remote area low-altitude and landing capability. The project has resulted in a definition of system operational concept that includes a sensor subsystem, a sensor fusion/feature extraction capability, and a guidance and control law concept. These subsystem concepts have been developed to sufficient depth to enable further exploration within the NASA simulation environment, and to support programs leading to the flight test.

Human Milk for Ill and Medically Compromised Infants: Strategies and Ongoing Innovation.

PubMed

DiLauro, Sara; Unger, Sharon; Stone, Debbie; O'Connor, Deborah L

2016-08-01

The use of human milk (mother's own milk and/or donor milk) in ill or medically compromised infants frequently requires some adaptation to address medical diagnoses and/or altered nutrition requirements. This tutorial describes the nutrition and immunological benefits of breast milk as well as provides evidence for the use of donor milk when mother's own milk is unavailable. Several strategies used to modify human milk to meet the medical and nutrition needs of an ill or medically compromised infant are reviewed. These strategies include (1) the standard fortification of human milk to support adequate growth, (2) the novel concept of target fortification in preterm infants, (3) instructions on how to alter maternal diet to address cow's milk protein intolerance and/or allergy in breast milk-fed infants, and (4) the removal and modification of the fat in breast milk used in infants diagnosed with chylothorax. © 2016 American Society for Parenteral and Enteral Nutrition.

Strategic analysis of a water rights conflict in the south western United States.

PubMed

Philpot, Simone; Hipel, Keith; Johnson, Peter

2016-09-15

A strategic analysis of the ongoing conflict between Nevada and Utah, over groundwater allocation at Snake Valley, is carried out in order to investigate ways on how to resolve this dispute. More specifically, the Graph Model for Conflict Resolution is employed to formally model and analyze this conflict using the decision support system called GMCR+. The conflict analysis findings indicate that the dispute is enduring because of a lack of incentive and opportunity for any party to move beyond the present circumstances. Continued negotiations are not likely to resolve this conflict. A substantial change in the preferences or options of the disputants, or new governance tools will be required to move this conflict forward. This may hold lessons for future groundwater conflicts. It is, however, increasingly likely that the parties will require a third party intervention, such as equal apportionment by the US Supreme Court. Copyright © 2016 Elsevier Ltd. All rights reserved.

Loads and loads and loads: the influence of prospective load, retrospective load, and ongoing task load in prospective memory.

PubMed

Meier, Beat; Zimmermann, Thomas D

2015-01-01

In prospective memory tasks different kinds of load can occur. Adding a prospective memory task can impose a load on ongoing task performance. Adding ongoing task load (OTL) can affect prospective memory performance. The existence of multiple target events increases prospective load (PL) and adding complexity to the to-be-remembered action increases retrospective load (RL). In two experiments, we systematically examined the effects of these different types of load on prospective memory performance. Results showed an effect of PL on costs in the ongoing task for categorical targets (Experiment 2), but not for specific targets (Experiment 1). RL and OTL both affected remembering the retrospective component of the prospective memory task. We suggest that PL can enhance costs in the ongoing task due to additional monitoring requirements. RL and OTL seem to impact the division of resources between the ongoing task and retrieval of the retrospective component, which may affect disengagement from the ongoing task. In general, the results demonstrate that the different types of load affect prospective memory differentially.

Loads and loads and loads: the influence of prospective load, retrospective load, and ongoing task load in prospective memory

PubMed Central

Meier, Beat; Zimmermann, Thomas D.

2015-01-01

In prospective memory tasks different kinds of load can occur. Adding a prospective memory task can impose a load on ongoing task performance. Adding ongoing task load (OTL) can affect prospective memory performance. The existence of multiple target events increases prospective load (PL) and adding complexity to the to-be-remembered action increases retrospective load (RL). In two experiments, we systematically examined the effects of these different types of load on prospective memory performance. Results showed an effect of PL on costs in the ongoing task for categorical targets (Experiment 2), but not for specific targets (Experiment 1). RL and OTL both affected remembering the retrospective component of the prospective memory task. We suggest that PL can enhance costs in the ongoing task due to additional monitoring requirements. RL and OTL seem to impact the division of resources between the ongoing task and retrieval of the retrospective component, which may affect disengagement from the ongoing task. In general, the results demonstrate that the different types of load affect prospective memory differentially. PMID:26082709

Partnering to run a community-based program for deaf-blind young adults.

PubMed

Riester, A E

1992-12-01

Community-based programs that assist deaf-blind young adults with living skills can be a cost effective alternative to institutional care. Their unique medical, psychosocial training, and daily living needs require services and support from a variety of agencies and providers. The elements and concepts necessary to conduct a program 24 hours a day for young adults who are deaf and blind includes sound management, realistic staff expectations for clients, developmentally appropriate activities, family participation in planning accessible medical and psychological services, and close collaboration with universities and community organizations. Management must also be sensitive to the emotional concerns of the staff and provide ongoing opportunities for supervision and training.

Computer Science Research at Langley

NASA Technical Reports Server (NTRS)

Voigt, S. J. (Editor)

1982-01-01

A workshop was held at Langley Research Center, November 2-5, 1981, to highlight ongoing computer science research at Langley and to identify additional areas of research based upon the computer user requirements. A panel discussion was held in each of nine application areas, and these are summarized in the proceedings. Slides presented by the invited speakers are also included. A survey of scientific, business, data reduction, and microprocessor computer users helped identify areas of focus for the workshop. Several areas of computer science which are of most concern to the Langley computer users were identified during the workshop discussions. These include graphics, distributed processing, programmer support systems and tools, database management, and numerical methods.

Auditing of SNOMED CT's Hierarchical Structure using the National Drug File - Reference Terminology.

PubMed

Zakharchenko, Aleksandr; Geller, James

2015-01-01

With the ongoing development in the field of Medical Informatics, the availability of cross-references and the consistency of coverage between terminologies become critical requirements for clinical decision support. In this paper, we examine the possibility of developing a framework that highlights and exposes hierarchical incompatibilities between different medical terminologies in order to facilitate the process of achieving a sufficient level of consistency between terminologies. For the purpose of this research, we are working with the Systematized Nomenclature of Medicine--Clinical Terms (SNOMED CT) and the National Drug File--Reference Terminology (NDF-RT)--a clinical terminology focused on drugs. For discovery of inconsistencies we built an automated tool.

Astronaut Mark Linenger measures height of Astronaut Mark Lee during DSO

NASA Image and Video Library

1994-09-15

STS064-05-020 (9-20 Sept. 1994) --- Astronaut Mark C. Lee gets his height measured by astronaut Jerry M. Linenger as part of a daily in-flight routine supporting a medical Detailed Supplementary Objective (DSO). Astronaut Richard N. Richards, STS-64 mission commander, looks on in the background. This study was designed to collect information about back pain and height changes experienced by astronauts during flight. Crew members participating in this DSO are required to record height measurements and long back-pain symptoms daily. As an ongoing program, this DSO will gather data from 30 astronauts who spend more than eight consecutive days in space. Photo credit: NASA or National Aeronautics and Space Administration

Observational Search for Negative Matter in Intergalactic Voids

NASA Technical Reports Server (NTRS)

Forward, Robert L.

1999-01-01

Negative matter is a hypothetical form of matter with negative rest mass, inertial mass, and gravitational mass. It is not antimatter. If negative matter could be collected in macroscopic amounts, its negative inertial property could be used to make an continuously operating propulsion system which requires neither energy nor reaction mass, yet still violates no laws of physics. Negative matter has never been observed, but its existence is not forbidden by the laws of physics. We propose that NASA support an extension to an ongoing astrophysical observational effort by da Costa, et al. (1996) which could possibly determine whether or not negative matter exists in the well-documented but little-understood intergalactic voids.

Therapeutic Inertia and Treatment Intensification.

PubMed

Josiah Willock, Robina; Miller, Joseph B; Mohyi, Michelle; Abuzaanona, Ahmed; Muminovic, Meri; Levy, Phillip D

2018-01-29

This review aims to emphasize how therapeutic inertia, the failure of clinicians to intensify treatment when blood pressure rises or remains above therapeutic goals, contributes to suboptimal blood pressure control in hypertensive populations. Studies reveal that the therapeutic inertia is quite common and contributes to suboptimal blood pressure control. Quality improvement programs and standardized approaches to support antihypertensive treatment intensification are ways to combat therapeutic inertia. Furthermore, programs that utilize non-physician medical professionals such as pharmacists and nurses demonstrate promise in mitigating the effects of this important problem. Therapeutic inertia impedes antihypertensive management and requires a broad effort to reduce its effects. There is an ongoing need for renewed focus and research in this area to improve hypertension control.

Space-Based Information Services

NASA Astrophysics Data System (ADS)

Lee, C.

With useful data now beginning to flow from earth observation and navigation satellites, it is an active time for the development of space services - all types of satellites are now being put to work, not just Comsats. However derived products require a blend of innovative software design, low cost operational support and a real insight into the information needs of the customer. Science Systems is meeting this challenge through a series of on-going projects, three of which are summarised here (addressing navigation, communications and earth observation). By demonstrating a broad range of related disciplines; from monitoring and control to back-room billing; from data management to intelligent systems, Science Systems hopes to play a key role in this developing market.

International Space Station Aeromedical Support in Star City, Russia

NASA Technical Reports Server (NTRS)

Cole, Richard; Chamberlin, Blake; Dowell, Gene; Castleberry, Tarah; Savage, Scott

2010-01-01

The Space Medicine Division at Johnson Space Center works with the International Space Station s international partners (IP) to accomplish assigned health care tasks. Each IP may assign a flight surgeon to support their assigned crewmembers during all phases of training, in-flight operations, and postflight activities. Because of the extensive amount of astronaut training conducted in Star City; NASA, in collaboration with its IPs, has elected to keep a flight surgeon assigned to NASA s Star City office to provide support to the U.S., Canadian, Japanese, and European astronauts during hazardous training activities and provide support for any contingency landings of Soyuz spacecraft in Kazakhstan. The physician also provides support as necessary to the Mission Control Center in Moscow for non-Russian crew-related activities. In addition, the physician in Star City provides ambulatory medical care to the non-Russian-assigned personnel in Star City and visiting dependents. Additional work involves all medical supplies, administration, and inventory. The Star City physician assists in medical evacuation and/or in obtaining support from western clinics in Moscow when required care exceeds local resources. Overall, the Russians are responsible for operations and the medical care of the entire crew when training in Star City and during launch/landing operations. However, they allow international partner flight surgeons to care for their crewmembers as agreed to in the ISS Medical Operations Requirements Document. Medical support focuses on pressurized, monitored, and other hazardous training activities. One of the most important jobs is to act as a medical advocate for the astronauts and to reduce the threat that these hazardous activities pose. Although the Russians have a robust medical system, evacuation may be needed to facilitate ongoing medical care. There are several international medical evacuation companies that provide this care.

Integrated Cancer Research in Five Thematic Areas in Interest

DTIC Science & Technology

2005-07-01

Professor of Urology (on-going RSU), Howard Crawford, PhD, Assistant Professor of Pharmacological Sciences (on-going RSU), Marjana Maletic- Savatic ...young scientists. Drs. Adler, Crawford, Maletic- Savatic received base support from this mechanism as they further develop their research programs...Mirjana Maletic- Savatic , MD-PhD, Assistant Professor Neurology: Human Neural Stem Cells - In Vivo Models for Cerebral Carcinoma The study of human

Design and Implementation of an Interactive Website to Support Long-Term Maintenance of Weight Loss

PubMed Central

Stevens, Victor J; Brantley, Phillip J; Erlinger, Thomas P; Myers, Valerie H; Champagne, Catherine M; Bauck, Alan; Samuel-Hodge, Carmen D; Hollis, Jack F

2008-01-01

Background For most individuals, long-term maintenance of weight loss requires long-term, supportive intervention. Internet-based weight loss maintenance programs offer considerable potential for meeting this need. Careful design processes are required to maximize adherence and minimize attrition. Objective This paper describes the development, implementation and use of a Web-based intervention program designed to help those who have recently lost weight sustain their weight loss over 1 year. Methods The weight loss maintenance website was developed over a 1-year period by an interdisciplinary team of public health researchers, behavior change intervention experts, applications developers, and interface designers. Key interactive features of the final site include social support, self-monitoring, written guidelines for diet and physical activity, links to appropriate websites, supportive tools for behavior change, check-in accountability, tailored reinforcement messages, and problem solving and relapse prevention training. The weight loss maintenance program included a reminder system (automated email and telephone messages) that prompted participants to return to the website if they missed their check-in date. If there was no log-in response to the email and telephone automated prompts, a staff member called the participant. We tracked the proportion of participants with at least one log-in per month, and analyzed log-ins as a result of automated prompts. Results The mean age of the 348 participants enrolled in an ongoing randomized trial and assigned to use the website was 56 years; 63% were female, and 38% were African American. While weight loss data will not be available until mid-2008, website use remained high during the first year with over 80% of the participants still using the website during month 12. During the first 52 weeks, participants averaged 35 weeks with at least one log-in. Email and telephone prompts appear to be very effective at helping participants sustain ongoing website use. Conclusions Developing interactive websites is expensive, complex, and time consuming. We found that extensive paper prototyping well in advance of programming and a versatile product manager who could work with project staff at all levels of detail were essential to keeping the development process efficient. Trial Registration clinicaltrials.gov NCT00054925 PMID:18244892

22q11 deletion syndrome: Parents' and children's experiences of educational and healthcare provision in the United Kingdom.

PubMed

Cohen, Wendy; McCartney, Elspeth; Crampin, Lisa

2017-06-01

22q11 deletion syndrome (22q11DS) is a genetic syndrome, prevalence around 1:4000-1:6000 live births, with a complex array of associated features, impacting on healthcare and educational support. This study reports the perceptions of families and individuals with 22q11DS in relation to these needs. Individuals and families of those with 22q11DS were approached though two national charities - the Max Appeal and 22Crew. An initial observational survey design was used to gather views via questions probing access to healthcare and educational experiences. Thirty-four responses were received and the data subjected to descriptive analysis. Over half of the respondents were diagnosed before the age of 1. Ninety-one percent reported ongoing difficulties with learning at school, compounded by school attendance being compromised as a result of medical interventions. Individuals reported engaging heavily with educational support and a high number of health professions (mean 9.5; mode 10). Age of diagnosis of 22q11DS ranged from birth to nine years. Families had ongoing concerns about aspects of education and healthcare services, and lack of knowledge and awareness of the difficulties faced by individuals with 22q11DS was raised. Healthcare and education providers should be aware of the range of services individuals required on a regular basis so as to provide a more holistic approach to care.

Indoor Athletic Facilities.

ERIC Educational Resources Information Center

Fleming, E. Scott

2000-01-01

Examines the concept of shared-use facilities to help financially support and meet the demand for athletic facilities. Shared-use considerations are explored including cost sharing of ongoing operations, aesthetics, locker rooms, support facilities, parking and site access, and building access and security. (GR)

Maintaining the momentum of Open Search in Earth Science Data discovery

NASA Astrophysics Data System (ADS)

Newman, D. J.; Lynnes, C.

2013-12-01

Federated Search for Earth Observation data has been a hallmark of EOSDIS (Earth Observing System Data and Information System) for two decades. Originally, the EOSDIS Version 0 system provided both data-collection-level and granule/file-level search in the mid 1990s with EOSDIS-specific socket protocols and message formats. Since that time, the advent of several standards has helped to simplify EOSDIS federated search, beginning with HTTP as the transfer protocol. Most recently, OpenSearch (www.opensearch.org) was employed for the EOS Clearinghouse (ECHO), based on a set of conventions that had been developed within the Earth Science Information Partners (ESIP) Federation. The ECHO OpenSearch API has evolved to encompass the ESIP RFC and the Open Geospatial Consortium (OGC) Open Search standard. Uptake of the ECHO Open Search API has been significant and has made ECHO accessible to client developers that found the previous ECHO SOAP API and current REST API too complex. Client adoption of the OpenSearch API appears to be largely driven by the simplicity of the OpenSearch convention. This simplicity is thus important to retain as the standard and convention evolve. For example, ECHO metrics indicate that the vast majority of ECHO users favor the following search criteria when using the REST API, - Spatial - bounding box, polygon, line and point - Temporal - start and end time - Keywords - free text Fewer than 10% of searches use additional constraints, particularly those requiring a controlled vocabulary, such as instrument, sensor, etc. This suggests that ongoing standardization efforts around OpenSearch usage for Earth Observation data may be more productive if oriented toward improving support for the Spatial, Temporal and Keyword search aspects. Areas still requiring improvement include support of - Concrete requirements for keyword constraints - Phrasal search for keyword constraints - Temporal constraint relations - Terminological symmetry between search URLs and response documents for both temporal and spatial terms - Best practices for both servers and clients. Over the past year we have seen several ongoing efforts to further standardize Open Search in the earth science domain such as, - Federation of Earth Science Information Partners (ESIP) - Open Geospatial Consortium (OGC) - Committee on Earth Observation Satellites (CEOS)

Trialling an electronic decision aid for policy developers to support ageing well.

PubMed

Cummings, Elizabeth; Ellis, Leonie; Tin, Eh Eh; Boyer, Kim; Orpin, Peter

2015-01-01

The complex process of developing policies and planning services requires the compilation and collation of evidence from multiple sources. With the increasing numbers of people living longer there will be a high demand for a wide range of aged care services to support people in ageing well. The premise of ageing well is based on providing an ageing population with quality care and resources that support their ongoing needs. These include affordable healthcare, end of life care improvement, mental health services improvement, care and support improvement for people with dementia, and support for healthy ageing. The National Health and Medical Research Council funded a research project to develop a policy tool to provide a framework to assist policy makers and service planners in the area of ageing well in rural and regional Australia. It was identified that development of an electronic version of the policy tool could be useful resulting in a small pilot development being undertaken and tested with policy makers and service planners. This paper describes the development and trialling of a tablet based application used to assess the acceptability of computerised forms for participants actively involved in policy development. It reports on the policy developer's experience of the electronic tool to support ageing well policy making based on evidence.

Assessment and rehabilitation of driver skills: subjective experiences of people with multiple sclerosis and health professionals.

PubMed

Archer, Cherie; Morris, Libby; George, Stacey

2014-01-01

It is acknowledged in the literature that the physical and cognitive effects of the degenerative neurological condition of multiple sclerosis can impact upon driver safety. The aim of this study was to identify the experiences and needs of people with multiple sclerosis in relation to driver assessment and rehabilitation. Focus group discussions were conducted with people with multiple sclerosis (MS) who were: currently driving; no longer licensed or no longer driving and health professionals. The four themes that emerged from the data were: (1) from self-management to formal assessment - a journey of uncertainty and emotional dilemmas; (2) lost independence with grieving and adjustment by self and family; (3) alternative transport is challenging and unsatisfactory; (4) gaps in information and services exist. The results of this study highlight the need for ongoing support in relation to driving for people with MS, ranging from support for self-management, driving assessment and retraining, and preparation for loss of license. Standardised information needs to be developed and health professionals and licensing authorities require knowledge and skills to ensure driver assessment and rehabilitation processes and resources can better meet the needs of people with MS. There is a need for health professionals to examine driving in people with MS in a holistic manner taking into account the context for the person and the supports available. Self-management and self-assessment emerged as a preferred approach for the participants in this study, indicating that health professionals may need to engage with the process. Tools to support self-assessment of driving abilities for people with MS require further research. Indicators for review and formal assessment of driving abilities is needed. Alternative forms of transport require further investigation and improvement for people with MS.

The Dynamic Multiprocess Framework: Evidence from Prospective Memory with Contextual Variability

PubMed Central

Scullin, Michael K.; McDaniel, Mark A.; Shelton, Jill Talley

2013-01-01

The ability to remember to execute delayed intentions is referred to as prospective memory. Previous theoretical and empirical work has focused on isolating whether a particular prospective memory task is supported either by effortful monitoring processes or by cue-driven spontaneous processes. In the present work, we advance the Dynamic Multiprocess Framework, which contends that both monitoring and spontaneous retrieval may be utilized dynamically to support prospective remembering. To capture the dynamic interplay between monitoring and spontaneous retrieval we had participants perform many ongoing tasks and told them that their prospective memory cue may occur in any context. Following either a 20-min or a 12-hr retention interval, the prospective memory cues were presented infrequently across three separate ongoing tasks. The monitoring patterns (measured as ongoing task cost relative to a between-subjects control condition) were consistent and robust across the three contexts. There was no evidence for monitoring prior to the initial prospective memory cue; however, individuals who successfully spontaneously retrieved the prospective memory intention, thereby realizing that prospective memory cues could be expected within that context, subsequently monitored. These data support the Dynamic Multiprocess Framework, which contends that individuals will engage monitoring when prospective memory cues are expected, disengage monitoring when cues are not expected, and that when monitoring is disengaged, a probabilistic spontaneous retrieval mechanism can support prospective remembering. PMID:23916951

Principal Support Is Imperative to the Retention of Teachers in Hard-to-Staff Schools

ERIC Educational Resources Information Center

Hughes, Amy L; Matt, John J.; O'Reilly, Frances L.

2015-01-01

Teacher retention is an ongoing problem in hard-to-staff schools. This research examined the relationship between principal support and retention of teachers in hard-to-staff schools. The purpose of this study was to, (a) to determine the relationship between teacher retention and principal support, (b) to examine the perception of support between…

Birthing Support and the Community-Based Doula

ERIC Educational Resources Information Center

Abramson, Rachel; Breedlove, Ginger K.; Isaacs, Beth

2007-01-01

This article is excerpted from the authors' "The Community-Based Doula: Supporting Families Before, During, and After Childbirth", published in 2006 by "ZERO TO THREE." In the U.S., many new parents are socially isolated and lack access to ongoing caring and support because of poverty, immigration, language barriers, or the growing mobility and…

A comparison of high-speed links, their commercial support and ongoing R&D activities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gonzalez, H.L.; Barsotti, E.; Zimmermann, S.

Technological advances and a demanding market have forced the development of higher bandwidth communication standards for networks, data links and busses. Most of these emerging standards are gathering enough momentum that their widespread availability and lower prices are anticipated. The hardware and software that support the physical media for most of these links is currently available, allowing the user community to implement fairly high-bandwidth data links and networks with commercial components. Also, switches needed to support these networks are available or being developed. The commercial suppose of high-bandwidth data links, networks and switching fabrics provides a powerful base for themore » implementation of high-bandwidth data acquisition systems. A large data acquisition system like the one for the Solenoidal Detector Collaboration (SDC) at the SSC can benefit from links and networks that support an integrated systems engineering approach, for initialization, downloading, diagnostics, monitoring, hardware integration and event data readout. The issue that our current work addresses is the possibility of having a channel/network that satisfies the requirements of an integrated data acquisition system. In this paper we present a brief description of high-speed communication links and protocols that we consider of interest for high energy physic High Performance Parallel Interface (HIPPI). Serial HIPPI, Fibre Channel (FC) and Scalable Coherent Interface (SCI). In addition, the initial work required to implement an SDC-like data acquisition system is described.« less

A comparison of high-speed links, their commercial support and ongoing R D activities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gonzalez, H.L.; Barsotti, E.; Zimmermann, S.

Technological advances and a demanding market have forced the development of higher bandwidth communication standards for networks, data links and busses. Most of these emerging standards are gathering enough momentum that their widespread availability and lower prices are anticipated. The hardware and software that support the physical media for most of these links is currently available, allowing the user community to implement fairly high-bandwidth data links and networks with commercial components. Also, switches needed to support these networks are available or being developed. The commercial suppose of high-bandwidth data links, networks and switching fabrics provides a powerful base for themore » implementation of high-bandwidth data acquisition systems. A large data acquisition system like the one for the Solenoidal Detector Collaboration (SDC) at the SSC can benefit from links and networks that support an integrated systems engineering approach, for initialization, downloading, diagnostics, monitoring, hardware integration and event data readout. The issue that our current work addresses is the possibility of having a channel/network that satisfies the requirements of an integrated data acquisition system. In this paper we present a brief description of high-speed communication links and protocols that we consider of interest for high energy physic High Performance Parallel Interface (HIPPI). Serial HIPPI, Fibre Channel (FC) and Scalable Coherent Interface (SCI). In addition, the initial work required to implement an SDC-like data acquisition system is described.« less

Preface to QoIS 2009

NASA Astrophysics Data System (ADS)

Comyn-Wattiau, Isabelle; Thalheim, Bernhard

Quality assurance is a growing research domain within the Information Systems (IS) and Conceptual Modeling (CM) disciplines. Ongoing research on quality in IS and CM is highly diverse and encompasses theoretical aspects including quality definition and quality models, and practical/empirical aspects such as the development of methods, approaches and tools for quality measurement and improvement. Current research on quality also includes quality characteristics definitions, validation instruments, methodological and development approaches to quality assurance during software and information systems development, quality monitors, quality assurance during information systems development processes and practices, quality assurance both for data and (meta)schemata, quality support for information systems data import and export, quality of query answering, and cost/benefit analysis of quality assurance processes. Quality assurance is also depending on the application area and the specific requirements in applications such as health sector, logistics, public sector, financial sector, manufacturing, services, e-commerce, software, etc. Furthermore, quality assurance must also be supported for data aggregation, ETL processes, web content management and other multi-layered applications. Quality assurance is typically requiring resources and has therefore beside its benefits a computational and economical trade-off. It is therefore also based on compromising between the value of quality data and the cost for quality assurance.

Aerocapture Technology Development Needs for Outer Planet Exploration

NASA Technical Reports Server (NTRS)

Wercinski, Paul; Munk, Michelle; Powell, Richard; Hall, Jeff; Graves, Claude; Partridge, Harry (Technical Monitor)

2002-01-01

The purpose of this white paper is to identify aerocapture technology and system level development needs to enable NASA future mission planning to support Outer Planet Exploration. Aerocapture is a flight maneuver that takes place at very high speeds within a planet's atmosphere that provides a change in velocity using aerodynamic forces (in contrast to propulsive thrust) for orbit insertion. Aerocapture is very much a system level technology where individual disciplines such as system analysis and integrated vehicle design, aerodynamics, aerothermal environments, thermal protection systems (TPS), guidance, navigation and control (GN&C) instrumentation need to be integrated and optimized to meet mission specific requirements. This paper identifies on-going activities, their relevance and potential benefit to outer planet aerocapture that include New Millennium ST7 Aerocapture concept definition study, Mars Exploration Program aeroassist project level support, and FY01 Aeroassist In-Space Guideline tasks. The challenges of performing aerocapture for outer planet missions such as Titan Explorer or Neptune Orbiter require investments to advance the technology readiness of the aerocapture technology disciplines for the unique application of outer planet aerocapture. This white paper will identify critical technology gaps (with emphasis on aeroshell concepts) and strategies for advancement.

Effects of Anesthetics on Brain Circuit Formation

PubMed Central

Wagner, Meredith; Ryu, Yun Kyoung; Smith, Sarah C.; Mintz, C. David

2014-01-01

The results of several retrospective clinical studies suggest that exposure to anesthetic agents early in life is correlated with subsequent learning and behavioral disorders. While ongoing prospective clinical trials may help to clarify this association, they remain confounded by numerous factors. Thus, some of the most compelling data supporting the hypothesis that a relatively short anesthetic exposure can lead to a long-lasting change in brain function are derived from animal models. The mechanism by which such changes could occur remains incompletely understood. Early studies identified anesthetic-induced neuronal apoptosis as a possible mechanism of injury, and more recent work suggests that anesthetics may interfere with several critical processes in brain development. The function of the mature brain requires the presence of circuits, established during development, that perform the computations underlying learning and cognition. In this review we examine the mechanisms by which anesthetics could disrupt brain circuit formation, including effects on neuronal survival and neurogenesis, neurite growth and guidance, formation of synapses, and function of supporting cells. There is evidence that anesthetics can disrupt aspects of all of these processes, and further research is required to elucidate which are most relevant to pediatric anesthetic neurotoxicity. PMID:25144504

Ongoing training of community health workers in low-income and middle-income countries: a systematic scoping review of the literature

PubMed Central

O’Donovan, Charles; Kuhn, Isla; Sachs, Sonia Ehrlich

2018-01-01

Objectives Understanding the current landscape of ongoing training for community health workers (CHWs) in low-income and middle-income countries (LMICs) is important both for organisations responsible for their training, as well as researchers and policy makers. This scoping review explores this under-researched area by mapping the current delivery implementation and evaluation of ongoing training provision for CHWs in LMICs. Design Systematic scoping review. Data sources MEDLINE, Embase, AMED, Global Health, Web of Science, Scopus, ASSIA, LILACS, BEI and ERIC. Study selection Original studies focusing on the provision of ongoing training for CHWs working in a country defined as low income and middle income according to World Bank Group 2012 classification of economies. Results The scoping review found 35 original studies that met the inclusion criteria. Ongoing training activities for CHWs were described as supervision (n=19), inservice or refresher training (n=13) or a mixture of both (n=3). Although the majority of studies emphasised the importance of providing ongoing training, several studies reported no impact of ongoing training on performance indicators. The majority of ongoing training was delivered inperson; however, four studies reported the use of mobile technologies to support training delivery. The outcomes from ongoing training activities were measured and reported in different ways, including changes in behaviour, attitudes and practice measured in a quantitative manner (n=16), knowledge and skills (n=6), qualitative assessments (n=5) or a mixed methods approach combining one of the aforementioned modalities (n=8). Conclusions This scoping review highlights the diverse range of ongoing training for CHWs in LMICs. Given the expansion of CHW programmes globally, more attention should be given to the design, delivery, monitoring and sustainability of ongoing training from a health systems strengthening perspective. PMID:29705769

Students' Perspectives on Worldwide ``Greening'' of Tertiary Education Curricula

NASA Astrophysics Data System (ADS)

Aighewi, Isoken T.; Osaigbovo, Ulamen A.

2010-11-01

Several scholars have suggested the introduction of an environmental literacy requirement into the curricula of Non-Environmental Science disciplines in tertiary institutions of the world as a “greening” strategy for fostering global environmental stewardship necessary for enhancing understanding and collaboration in tackling the major environmental risks facing our global village today. However, there is no study on students’ opinion on this issue. This study was therefore initiated to 1) evaluate the opinion of undergraduate students on the introduction of a worldwide environmental literacy into the curricula of Non-Environmental science majors as a graduation requirement; and 2) identify any possible demographic differences in opinions among the student subjects polled. We sought the opinion of 800 undergraduates from African, North American and European universities on the subject and 99% responded. The result showed that a majority (67%) of them supported the worldwide environmental literacy requirement and those already trained were significantly ( P < 0.0001) more likely to support it than those untrained. Students from developing countries were significantly ( P < 0.0001) more likely to support it than those from developed countries; similarly students in the Arts’ disciplines were more likely to support it than Non-Arts’ students as a group. However, no significant differences were observed between students from Francophone versus Anglophone countries; Social Sciences versus Non-Social Sciences majors and between Education versus Non-Education majors. Some similarities were observed between the opinion of university-age students in this study and 15-year old secondary school students from two major international surveys (Research on Science Education-ROSE, and Program for International Student Assessment-PISA) on science education; further studies comparing these two categories of students is suggested. The need for all professionals to be literate about the science of their surroundings was the most identified reason for supporting the literacy requirement by the students polled. The results of this study thus provide evidence of support by students in the on-going paradigm shift towards “greening” the curricula of tertiary institutions and thus reinforces its implementation by leaders of academe and policy makers worldwide.

Implementation of a Transdisciplinary Team for the Transition Support of Medically and Socially Complex Youth.

PubMed

Ciccarelli, Mary R; Gladstone, Erin B; Armstrong Richardson, Eprise A J

2015-01-01

This article reports the ongoing work of a statewide transition support program which serves youth ages 11 to 22 with medically complex conditions and socially complex lives. Seven years of transition support services have led to program evolution demonstrated via a descriptive summary of the patients along with both families' and primary care providers' responses to satisfaction surveys. An illustrative case is used to highlight the types of expertise needed in specialized transition service delivery for patients with significant complexity. The team's analysis of their transdisciplinary work processes further explains the work. Nearly three hundred youth with complex needs are served yearly. Families and primary care providers express high satisfaction with the support of the services. The case example shows the broad array of transition-specific services engaged beyond the usual skill set of pediatric or adult care coordination teams. Transdisciplinary team uses skills in collaboration, support, learning, and compromise within a trusting and respectful environment. They describe the shared responsibility and continuous learning of the whole team. Youth with complex medical conditions and complex social situations are at higher risk for problems during transition. Serving this population with a transdisciplinary model is time consuming and requires advanced expertise but, with those investments, we can meet the expectations of the youth, their families and primary care providers. Successful transdisciplinary teamwork requires sustained and focused investment. Further work is needed to describe the complexity of this service delivery along with distinct transition outcomes and costs comparisons. Copyright © 2015 Elsevier Inc. All rights reserved.

Opinions of health care professionals and the public after eight years of euthanasia legislation in the Netherlands: a mixed methods approach.

PubMed

Kouwenhoven, Pauline S C; Raijmakers, Natasja J H; van Delden, Johannes J M; Rietjens, Judith A C; Schermer, Maartje H N; van Thiel, Ghislaine J M W; Trappenburg, Margo J; van de Vathorst, Suzanne; van der Vegt, Bea J; Vezzoni, Cristiano; Weyers, Heleen; van Tol, Donald G; van der Heide, Agnes

2013-03-01

The practice of euthanasia and physician-assisted suicide (PAS) in the Netherlands has been regulated since 2002 by the Euthanasia Act. In the ongoing debate about the interpretation of this Act, comparative information about the opinions of the different stakeholders is needed. To evaluate the opinions of Dutch physicians, nurses and the general public on the legal requirements for euthanasia and PAS. A cross-sectional survey among Dutch physicians and nurses in primary and secondary care and members of the Dutch general public, followed by qualitative interviews among selected respondents. The participants were: 793 physicians, 1243 nurses and 1960 members of the general public who completed the questionnaire; 83 were interviewed. Most respondents agreed with the requirement of a patient request (64-88%) and the absence of a requirement concerning life expectancy (48-71%). PAS was thought acceptable by 24-39% of respondents for patients requesting it because of mental suffering due to loss of control, chronic depression or early dementia. In the case of severe dementia, one third of physicians, 58% of nurses and 77% of the general public agreed with performing euthanasia based on an advance directive. Interviewees illustrated these findings and supported the Act. Health care professionals and the general public mostly support the legal requirements for euthanasia and PAS. The law permits euthanasia or PAS for mental suffering but this possibility is not widely endorsed. The general public is more liberal towards euthanasia for advanced dementia than health care professionals. We conclude that there is ample support for the law after eight years of legal euthanasia.

Impact of a web based interactive simulation game (PULSE) on nursing students' experience and performance in life support training--a pilot study.

PubMed

Cook, Neal F; McAloon, Toni; O'Neill, Philip; Beggs, Richard

2012-08-01

The delivery of effective life support measures is highly associated with the quality, design and implementation of the education that underpins it. Effectively responding to a critical event is a requirement for all nurses illustrating the need for effective educational approaches from pre-registration training through to enhancing and maintaining life support skills after qualification. This paper reports the findings of utilising a web-based multimedia simulation game PULSE (Platform for Undergraduate Life Support Education). The platform was developed to enhance the student experience of life support education, to motivate on-going learning and engagement and to improve psychomotor skills associated with the provision of Intermediate Life Support (ILS) training. Pre training participants played PULSE and during life support training data was collected from an intervention and a control group of final year undergraduate nursing students (N=34). Quantitative analysis of performance took place and qualitative data was generated from a questionnaire assessing the learning experience. A statistically significant difference was found between the competence the groups displayed in the three skills sets of checking equipment, airway assessment and the safe/effective use of defibrillator at ILS level, and PULSE was positively evaluated as an educational tool when used alongside traditional life support training. Copyright © 2011 Elsevier Ltd. All rights reserved.

Impact of Biofilms on the Design and Operation of ISS Life Support Systems

NASA Technical Reports Server (NTRS)

Carter, Donald Layne; Brown, Chris

2017-01-01

Biofilm growth has been an ongoing issue for US and Russian water systems on the International Space Station, and is a critical issue for exploration missions in which water systems must be designed to accommodate dormant periods of up to one year. On ISS, Russian condensate plumbing has previously clogged with biomass, requiring condensate plumbing to now be regularly replaced. In the US Segment, the release of biofilm from the Water Processor waste tank has clogged a solenoid valve downstream of the tank, resulting in the costly replacement of the inlet separator and process pump. Subsequent management of the biofilm in the waste tank involves restrictions on tank cycles to limit the release of biomass and an additional filter to protect downstream components. Engineering personnel are now evaluating concepts to better manage the biomass, including the use of microbial inhibitors and UV LEDs. Though current ISS operations could likely be sustained for the duration of ISS, a more effective method must be developed for managing the growth and release of biomass in future exploration vehicles. Biofilm management for future missions is complicated by the requirement to accommodate extended periods of dormancy during which time the water system will be stagnant. The current approach under consideration is to flush the waste water with product water to reduce the organic content followed by use of microbial inhibitors or UV. However, other concepts may also be developed based on ongoing research.

Leadership and emotional intelligence in nursing and midwifery education and practice: a discussion paper.

PubMed

Carragher, Jean; Gormley, Kevin

2017-01-01

A discussion of the concepts of leadership and emotional intelligence in nursing and midwifery education and practice. The need for emotionally intelligent leadership in the health professions is acknowledged internationally throughout the nursing and midwifery literature. The concepts of emotional intelligence and emotional-social intelligence have emerged as important factors for effective leadership in the healthcare professions and require further exploration and discussion. This paper will explore these concepts and discuss their importance in the healthcare setting with reference to current practices in the UK, Ireland and internationally. Discussion paper. A search of published evidence from 1990-2015 using key words (as outlined below) was undertaken from which relevant sources were selected to build an informed discussion. Fostering emotionally intelligent leadership in nursing and midwifery supports the provision of high quality and compassionate care. Globally, leadership has important implications for all stakeholders in the healthcare professions with responsibility for maintaining high standards of care. This includes all grades of nurses and midwives, students entering the professions, managerial staff, academics and policy makers. This paper discusses the conceptual models of leadership and emotional intelligence and demonstrates an important link between the two. Further robust studies are required for ongoing evaluation of the different models of emotional intelligence and their link with effective leadership behaviour in the healthcare field internationally. This is of particular significance for professional undergraduate education to promote ongoing compassionate, safe and high quality standards of care. © 2016 John Wiley & Sons Ltd.

Human factors in waste management - potential and reality

DOE Office of Scientific and Technical Information (OSTI.GOV)

Thompson, J.S.

There is enormous potential for human factors contributions in the realm of waste management. The reality, however, is very different from the potential. This is particularly true for low-level and low-level mixed-waste management. The hazards are less severe; therefore, health and safety requirements (including human factors) are not as rigorous as for high-level waste. High-level waste management presents its own unique challenges and opportunities. Waste management is strongly driven by regulatory compliance. When regulations are flexible and open to interpretation and the environment is driven so strongly by regulatory compliance, standard practice is to drop {open_quotes}nice to have{close_quotes} features, likemore » a human factors program, to save money for complying with other requirements. The challenge is to convince decision makers that human factors can help make operations efficient and cost-effective, as well as improving safety and complying with regulations. A human factors program should not be viewed as competing with compliance efforts; in fact, it should complement them and provide additional cost-effective means of achieving compliance with other regulations. Achieving this synergy of human factors with ongoing waste management operations requires educating program and facility managers and other technical specialists about human factors and demonstrating its value {open_quotes}through the back door{close_quotes} on existing efforts. This paper describes ongoing projects at Los Alamos National Laboratory (LANL) in support of their waste management groups. It includes lessons learned from hazard and risk analyses, safety analysis reports, job and task analyses, operating procedure development, personnel qualification/certification program development, and facility- and job-specific training program and course development.« less

Mathematical biology modules based on modern molecular biology and modern discrete mathematics.

PubMed

Robeva, Raina; Davies, Robin; Hodge, Terrell; Enyedi, Alexander

2010-01-01

We describe an ongoing collaborative curriculum materials development project between Sweet Briar College and Western Michigan University, with support from the National Science Foundation. We present a collection of modules under development that can be used in existing mathematics and biology courses, and we address a critical national need to introduce students to mathematical methods beyond the interface of biology with calculus. Based on ongoing research, and designed to use the project-based-learning approach, the modules highlight applications of modern discrete mathematics and algebraic statistics to pressing problems in molecular biology. For the majority of projects, calculus is not a required prerequisite and, due to the modest amount of mathematical background needed for some of the modules, the materials can be used for an early introduction to mathematical modeling. At the same time, most modules are connected with topics in linear and abstract algebra, algebraic geometry, and probability, and they can be used as meaningful applied introductions into the relevant advanced-level mathematics courses. Open-source software is used to facilitate the relevant computations. As a detailed example, we outline a module that focuses on Boolean models of the lac operon network.

Tenure Track Investigator | Center for Cancer Research

Cancer.gov

The Neuro-Oncology Branch (NOB), Center for Cancer Research (CCR) of the National Cancer Institute (NCI), National Institutes of Health (NIH), Department of Health and Human Services (HHS), Bethesda, MD, is actively recruiting for a tenure-track principal investigator to work in the area of immunology and/or immunotherapy.  The NOB Immunology/Immunotherapy Investigator will be tasked with forming and leading an independent research program.  This position will build the basic immunology program in the NOB and complement ongoing and planned translational research and clinical trials evaluating the effects of immunotherapy in patients with primary brain tumors.  This program will be able to access biospecimens generated from ongoing and planned immunotherapy protocols within the NOB, thus creating an opportunity to perform correlative studies to interrogate the complex biology of immunologic response, toxicity, and treatment resistance.  Demonstrated expertise in scientific inquiries in immunotherapy and/or immunology are essential, but prior work in brain tumors is not required.  This is an exciting opportunity to join a growing trans-institutional research team that promotes and supports collaborations across the basic, translational, and clinical research spectrum to develop novel therapeutics for individuals with primary central nervous system malignancies that will globally influence the field.

NASA Johnson Space Center Usability Testing and Analysis facility (UTAF) Overview

NASA Technical Reports Server (NTRS)

Whitmore, Mihriban; Holden, Kritina L.

2005-01-01

The Usability Testing and Analysis Facility (UTAF) is part of the Space Human Factors Laboratory at the NASA Johnson Space Center in Houston, Texas. The facility performs research for NASA's HumanSystems Integration Program, under the HumanSystems Research and Technology Division. Specifically, the UTAF provides human factors support for space vehicles, including the International Space Station, the Space Shuttle, and the forthcoming Crew Exploration Vehicle. In addition, there are ongoing collaborative research efforts with external corporations and universities. The UTAF provides human factors analysis, evaluation, and usability testing of crew interfaces for space applications. This includes computer displays and controls, workstation systems, and work environments. The UTAF has a unique mix of capabilities, with a staff experienced in both cognitive human factors and ergonomics. The current areas of focus are: human factors applications in emergency medical care and informatics; control and display technologies for electronic procedures and instructions; voice recognition in noisy environments; crew restraint design for unique microgravity workstations; and refinement of human factors processes and requirements. This presentation will provide an overview of ongoing activities, and will address how the UTAF projects will evolve to meet new space initiatives.

Mathematical Biology Modules Based on Modern Molecular Biology and Modern Discrete Mathematics

PubMed Central

Davies, Robin; Hodge, Terrell; Enyedi, Alexander

2010-01-01

We describe an ongoing collaborative curriculum materials development project between Sweet Briar College and Western Michigan University, with support from the National Science Foundation. We present a collection of modules under development that can be used in existing mathematics and biology courses, and we address a critical national need to introduce students to mathematical methods beyond the interface of biology with calculus. Based on ongoing research, and designed to use the project-based-learning approach, the modules highlight applications of modern discrete mathematics and algebraic statistics to pressing problems in molecular biology. For the majority of projects, calculus is not a required prerequisite and, due to the modest amount of mathematical background needed for some of the modules, the materials can be used for an early introduction to mathematical modeling. At the same time, most modules are connected with topics in linear and abstract algebra, algebraic geometry, and probability, and they can be used as meaningful applied introductions into the relevant advanced-level mathematics courses. Open-source software is used to facilitate the relevant computations. As a detailed example, we outline a module that focuses on Boolean models of the lac operon network. PMID:20810955

Ebola Virus Training: A Needs Assessment and Gap Analysis.

PubMed

Yeskey, Kevin; Hughes, Joseph; Galluzzo, Betsy; Jaitly, Nina; Remington, James; Weinstock, Deborah; Lee Pearson, Joy; Rosen, Jonathan D

In response to the 2014 Ebola virus disease outbreak, the Worker Training Program embarked on an assessment of existing training for those at risk for exposure to the virus. Searches of the recent peer-reviewed literature were conducted for descriptions of relevant training. Federal guidance issued during 2015 was also reviewed. Four stakeholder meetings were conducted with representatives from health care, academia, private industry, and public health to discuss issues associated with ongoing training. Our results revealed few articles about training that provided sufficient detail to serve as models. Training programs struggled to adjust to frequently updated federal guidance. Stakeholders commented that most healthcare training focused solely on infection control, and there was an absence of employee health-related training for non-healthcare providers. Challenges to ongoing training included funding and organizational complacency. Best practices were noted where management and employees planned training cooperatively and where infection control, employee health, and hospital emergency managers worked together on the development of protective guidance. We conclude that sustainable training for infectious disease outbreaks requires annual funding, full support from organizational management, input from all stakeholders, and integration of infection control, emergency management, and employee health when implementing guidance and training.

How Physician Perspectives on E-Prescribing Evolve over Time

PubMed Central

Patel, Vaishali; Pfoh, Elizabeth R.; Kaushal, Rainu

2016-01-01

Summary Background Physicians are expending tremendous resources transitioning to new electronic health records (EHRs), with electronic prescribing as a key functionality of most systems. Physician dissatisfaction post-transition can be quite marked, especially initially. However, little is known about how physicians’ experiences using new EHRs for e-prescribing evolve over time. We previously published a qualitative case study about the early physician experience transitioning from an older to a newer, more robust EHR, in the outpatient setting, focusing on their perceptions of the electronic prescribing functionality. Objective Our current objective was to examine how perceptions about using the new HER evolved over time, again with a focus on electronic prescribing. Methods We interviewed thirteen internists at an academic medical center-affiliated ambulatory care clinic who transitioned to the new EHR two years prior. We used a grounded theory approach to analyze semi-structured interviews and generate key themes. Results We identified five themes: efficiency and usability, effects on safety, ongoing training requirements, customization, and competing priorities for the EHR. We found that for even experienced e-prescribers, achieving prior levels of perceived prescribing efficiency took nearly two years. Despite the fact that speed in performing prescribing-related tasks was highly important, most were still not utilizing system short cuts or customization features designed to maximize efficiency. Alert fatigue remained common. However, direct transmission of prescriptions to pharmacies was highly valued and its benefits generally outweighed the other features considered poorly designed for physician workflow. Conclusions Ensuring that physicians are able to do key prescribing tasks efficiently is critical to the perceived value of e-prescribing applications. However, successful transitions may take longer than expected and e-prescribing system features that do not support workflow or require constant upgrades may further prolong the process. Additionally, as system features continually evolve, physicians may need ongoing training and support to maintain efficiency. PMID:27786335

Reflective Supervision: A Clinical Supervision Model for Fostering Professional Growth

ERIC Educational Resources Information Center

Costello, Lisa H.; Belcaid, Erin; Arthur-Stanley, Amanda

2018-01-01

School psychologists experience a broad range of stressors in their role as school support professionals including feelings of isolation, insufficient resources, administrative pressures, and excessive caseloads (Boccio, Wiesz, & Lefkowitz, 2016). Ongoing support is necessary to help school psychologists successfully navigate these…

IDAHO NATIONAL LABORATORY TRANSPORTATION TASK REPORT ON ACHIEVING MODERATOR EXCLUSION AND SUPPORTING STANDARDIZED TRANSPORTATION

DOE Office of Scientific and Technical Information (OSTI.GOV)

D.K. Morton

2011-09-01

Following the defunding of the Yucca Mountain Project, it is reasonable to assume that commercial used fuel will remain in storage for the foreseeable future. This report proposes supplementing the ongoing research and development work related to potential degradation of used fuel, baskets, poisons, and storage canisters during an extended period of storage with a parallel path. This parallel path can assure criticality safety during transportation by implementing a concept that achieves moderator exclusion (no in-leakage of moderator into the used fuel cavity). Using updated risk assessment insights for additional technical justification and relying upon a component inside of themore » transportation cask that provides a watertight function, a strong argument can be made that moderator intrusion is not credible and should not be a required assumption for criticality evaluations during normal conditions of transportation. A demonstrating testing program supporting a detailed analytical effort as well as updated risk assessment insights can provide the basis for moderator exclusion during hypothetical accident conditions. This report also discusses how this engineered concept can support the goal of standardized transportation.« less

Innovating science communication: the structure supporting ATLAS Education & Outreach

NASA Astrophysics Data System (ADS)

Goldfarb, Steven; Marcelloni, Claudia; Shaw, Kate; ATLAS Experiment

2016-04-01

The ATLAS Education & Outreach project has, over the years, developed a strong reputation for supporting innovation. Animated event displays, musical CDs, 3d movies, 3-storey murals, photo books, data sonifications, multi-media art installations, pub slams, masterclasses, documentaries, pop-up books, LEGO® models, and virtual visits are among the many diverse methods being exploited to communicate to the world the goals and accomplishments of the ATLAS Experiment at CERN. This variety of creativity and innovation does not pop out of a vacuum. It requires underlying motivation by the collaboration to communicate with the public; freedom and encouragement to do so in a creative manner; and a support structure for developing, implementing and promoting these activities. The ATLAS Outreach project has built this support structure on a well-defined communication plan, high-quality content, and effective delivery platforms. Most importantly, implementation of the program has been based on the effective engagement of the participating institutes and other key partners, not only to leverage modest human resources and funding, but also to take advantage of the rich imagination and inspiration of a diverse, global human collaboration. We present our current plan, on-going activities, and a few more fun innovations for the future.

Near-Infrared Neuroimaging with NinPy

PubMed Central

Strangman, Gary E.; Zhang, Quan; Zeffiro, Thomas

2009-01-01

There has been substantial recent growth in the use of non-invasive optical brain imaging in studies of human brain function in health and disease. Near-infrared neuroimaging (NIN) is one of the most promising of these techniques and, although NIN hardware continues to evolve at a rapid pace, software tools supporting optical data acquisition, image processing, statistical modeling, and visualization remain less refined. Python, a modular and computationally efficient development language, can support functional neuroimaging studies of diverse design and implementation. In particular, Python's easily readable syntax and modular architecture allow swift prototyping followed by efficient transition to stable production systems. As an introduction to our ongoing efforts to develop Python software tools for structural and functional neuroimaging, we discuss: (i) the role of non-invasive diffuse optical imaging in measuring brain function, (ii) the key computational requirements to support NIN experiments, (iii) our collection of software tools to support NIN, called NinPy, and (iv) future extensions of these tools that will allow integration of optical with other structural and functional neuroimaging data sources. Source code for the software discussed here will be made available at www.nmr.mgh.harvard.edu/Neural_SystemsGroup/software.html. PMID:19543449

Ernest Orlando Lawrence Berkeley National Laboratory Institutional Plan FY 2000-2004

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chartock, Mike; Hansen, Todd

1999-08-01

The FY 2000-2004 Institutional Plan provides an overview of the Ernest Orlando Lawrence Berkeley National Laboratory (Berkeley Lab, the Laboratory) mission, strategic plan, initiatives, and the resources required to fulfill its role in support of national needs in fundamental science and technology, energy resources, and environmental quality. To advance the Department of Energy's ongoing efforts to define the Integrated Laboratory System, the Berkeley Lab Institutional Plan reflects the strategic elements of our planning efforts. The Institutional Plan is a management report that supports the Department of Energy's mission and programs and is an element of the Department of Energy's strategicmore » management planning activities, developed through an annual planning process. The Plan supports the Government Performance and Results Act of 1993 and complements the performance-based contract between the Department of Energy and the Regents of the University of California. It identifies technical and administrative directions in the context of the national energy policy and research needs and the Department of Energy's program planning initiatives. Preparation of the plan is coordinated by the Office of Planning and Communications from information contributed by Berkeley Lab's scientific and support divisions.« less

Hope for successful implementation of psychosocial/psychiatric rehabilitation in the forensic mental health setting.

PubMed

Brown, Stephanie A; Lewis, Kent

2015-12-01

To explore staff perceptions of the successes and barriers to implementation of the psychosocial/psychiatric rehabilitation (PSR) model in the forensic mental health setting and identify staff supports needed for greater implementation. A qualitative descriptive design was used and staff focus group data was analyzed using the constant comparative method. All aspects of PSR are being implemented in the forensic setting. Barriers limiting comprehensive implementation include hospital processes and functions, legal components, client clinical presentation, staff attributes and interactions, and lack of resources. To foster greater implementation, employees require support to improve interprofessional interactions and acquire additional resources and education. Strengthening existing successes and addressing barriers identified will foster greater PSR implementation in the forensic setting. Adjusting the physical environment, streamlining documentation, shifting focus from security to rehabilitation goals, and adapting PSR principles to various levels of illness acuity and stages of treatment would enhance PSR implementation. A management focus on improving staff morale, self-care, peer support, team cohesion, and communication would limit burnout and increase successful implementation of PSR. Additional educational opportunities and ongoing training are suggested to support a unified understanding and sustained approach to PSR implementation in the forensic setting. (c) 2015 APA, all rights reserved).

Healthcare Managers' Experiences of Leading the Implementation of Video Conferencing in Discharge Planning Sessions: An Interview Study.

PubMed

Hofflander, Malin; Nilsson, Lina; Eriksén, Sara; Borg, Christel

2016-03-01

This article describes healthcare managers' experiences of leading the implementation of video conferencing in discharge planning sessions as a new tool in everyday practice. Data collection took place through individual interviews and the interviews were analyzed using qualitative content analysis with an inductive approach. The results indicate that managers identified two distinct leadership perspectives when they reflected on the implementation process. They described a desired way of leading the implementation and communicating about the upcoming change, understanding and securing support for decisions, as well as ensuring that sufficient time is available throughout the change process. They also, however, described how they perceived that the implementation process was actually taking place, highlighting the lack of planning and preparation as well as the need for support and to be supportive, and having the courage to adopt and lead the implementation. It is suggested that managers at all levels require more information and training in how to encourage staff to become involved in designing their everyday work and in the implementation process. Managers, too, need ongoing organizational support for good leadership throughout the implementation of video conferencing in discharge planning sessions, including planning, start-up, implementation, and evaluation.

An Examination of Behavioral Rehearsal During Consultation as a Predictor of Training Outcomes

PubMed Central

Kendall, Philip C.; Ringle, Vanesa A.; Read, Kendra L.; Brodman, Douglas A.; Pimentel, Sandra S.; Beidas, Rinad S.

2013-01-01

The training literature suggests that ongoing support following initial therapist training enhances training outcomes, yet little is known about what occurs during ongoing support and what accounts for its effectiveness. The present study examined consultation sessions provided to 99 clinicians following training in cognitive-behavioral therapy for youth anxiety. The 104 recorded consultation sessions were coded for content and consultative methods. It was hypothesized that behavioral rehearsal (an active learning technique) would predict therapist adherence, skill, self-efficacy, and satisfaction at post-consultation. Regression analyses found no significant relation, however, clinician involvement during consultation sessions positively moderated the relationship between behavioral rehearsals and skill. Implications, limitations, and future directions are discussed. PMID:23616234

Thermal Imaging for Inspection of Large Cryogenic Tanks

NASA Technical Reports Server (NTRS)

Arens, Ellen

2012-01-01

The end of the Shuttle Program provides an opportunity to evaluate and possibly refurbish launch support infrastructure at the Kennedy Space Center in support of future launch vehicles. One major infrastructure element needing attention is the cryogenic fuel and oxidizer system and specifically the cryogenic fuel ground storage tanks located at Launch Complex 39. These tanks were constructed in 1965 and served both the Apollo and Shuttle Programs and will be used to support future launch programs. However, they have received only external inspection and minimal refurbishment over the years as there were no operational issues that warranted the significant time and schedule disruption required to drain and refurbish the tanks while the launch programs were ongoing. Now, during the break between programs, the health of the tanks is being evaluated and refurbishment is being performed as necessary to maintain their fitness for future launch programs. Thermography was used as one part of the inspection and analysis of the tanks. This paper will describe the conclusions derived from the thermal images to evaluate anomalous regions in the tanks, confirm structural integrity of components within the annular region, and evaluate the effectiveness of thermal imaging to detect large insulation voids in tanks prior to filling with cryogenic fluid. The use of thermal imaging as a tool to inspect unfilled tanks will be important if the construction of additional storage tanks is required to fuel new launch vehicles.

Interventions to improve or facilitate linkage to or retention in pre-ART (HIV) care and initiation of ART in low- and middle-income settings – a systematic review

PubMed Central

Govindasamy, Darshini; Meghij, Jamilah; Negussi, Eyerusalem Kebede; Baggaley, Rachel Clare; Ford, Nathan; Kranzer, Katharina

2014-01-01

Introduction Several approaches have been taken to reduce pre-antiretroviral therapy (ART) losses between HIV testing and ART initiation in low- and middle-income countries, but a systematic assessment of the evidence has not yet been undertaken. The aim of this systematic review is to assess the potential for interventions to improve or facilitate linkage to or retention in pre-ART care and initiation of ART in low- and middle-income settings. Methods An electronic search was conducted on Medline, Embase, Global Health, Web of Science and conference databases to identify studies describing interventions aimed at improving linkage to or retention in pre-ART care or initiation of ART. Additional searches were conducted to identify on-going trials on this topic, and experts in the field were contacted. An assessment of the risk of bias was conducted. Interventions were categorized according to key domains in the existing literature. Results A total of 11,129 potentially relevant citations were identified, of which 24 were eligible for inclusion, with the majority (n=21) from sub-Saharan Africa. In addition, 15 on-going trials were identified. The most common interventions described under key domains included: health system interventions (i.e. integration in the setting of antenatal care); patient convenience and accessibility (i.e. point-of-care CD4 count (POC) testing with immediate results, home-based ART initiation); behaviour interventions and peer support (i.e. improved communication, patient referral and education) and incentives (i.e. food support). Several interventions showed favourable outcomes: integration of care and peer supporters increased enrolment into HIV care, medical incentives increased pre-ART retention, POC CD4 testing and food incentives increased completion of ART eligibility screening and ART initiation. Most studies focused on the general adult patient population or pregnant women. The majority of published studies were observational cohort studies, subject to an unclear risk of bias. Conclusions Findings suggest that streamlining services to minimize patient visits, providing adequate medical and peer support, and providing incentives may decrease attrition, but the quality of the current evidence base is low. Few studies have investigated combined interventions, or assessed the impact of interventions across the HIV cascade. Results from on-going trials investigating POC CD4 count testing, patient navigation, rapid ART initiation and mobile phone technology may fill the quality of evidence gap. Further high-quality studies on key population groups are required, with interventions informed by previously reported barriers to care. PMID:25095831

The Vanderbilt University nanoscale science and engineering fabrication laboratory

NASA Astrophysics Data System (ADS)

Hmelo, Anthony B.; Belbusti, Edward F.; Smith, Mark L.; Brice, Sean J.; Wheaton, Robert F.

2005-08-01

Vanderbilt University has realized the design and construction of a 1635 sq. ft. Class 10,000 cleanroom facility to support the wide-ranging research mission associated with the Vanderbilt Institute for Nanoscale Science and Engineering (VINSE). By design we have brought together disparate technologies and researchers formerly dispersed across the campus to work together in a small contiguous space intended to foster interaction and synergy of nano-technologies not often found in close proximity. The space hosts a variety of tools for lithographic patterning of substrates, the deposition of thin films, the synthesis of diamond nanostructures and carbon nanotubes, and a variety of reactive ion etchers for the fabrication of nanostructures on silicon substrates. In addition, a separate 911 sq. ft. chemistry laboratory supports nanocrystal synthesis and the investigation of biomolecular films. The design criteria required an integrated space that would support the scientific agenda of the laboratory while satisfying all applicable code and safety concerns. This project required the renovation of pre-existing laboratory space with minimal disruption to ongoing activities in a mixed-use building, while meeting the requirements of the 2000 edition of the International Building Code for the variety of potentially hazardous processes that have been programmed for the space. In this paper we describe how architectural and engineering challenges were met in the areas of mitigating floor vibration issues, shielding our facility against EMI emanations, design of the contamination control facility itself, chemical storage and handling, toxic gas use and management, as well as mechanical, electrical, plumbing, lab security, fire and laboratory safety issues.

Deep Borehole Disposal Concept: Development of Universal Canister Concept of Operations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rigali, Mark J.; Price, Laura L.

This report documents key elements of the conceptual design for deep borehole disposal of radioactive waste to support the development of a universal canister concept of operations. A universal canister is a canister that is designed to be able to store, transport, and dispose of radioactive waste without the canister having to be reopened to treat or repackage the waste. This report focuses on the conceptual design for disposal of radioactive waste contained in a universal canister in a deep borehole. The general deep borehole disposal concept consists of drilling a borehole into crystalline basement rock to a depth ofmore » about 5 km, emplacing WPs in the lower 2 km of the borehole, and sealing and plugging the upper 3 km. Research and development programs for deep borehole disposal have been ongoing for several years in the United States and the United Kingdom; these studies have shown that deep borehole disposal of radioactive waste could be safe, cost effective, and technically feasible. The design concepts described in this report are workable solutions based on expert judgment, and are intended to guide follow-on design activities. Both preclosure and postclosure safety were considered in the development of the reference design concept. The requirements and assumptions that form the basis for the deep borehole disposal concept include WP performance requirements, radiological protection requirements, surface handling and transport requirements, and emplacement requirements. The key features of the reference disposal concept include borehole drilling and construction concepts, WP designs, and waste handling and emplacement concepts. These features are supported by engineering analyses.« less

Emerging models for mobilizing family support for chronic disease management: a structured review.

PubMed

Rosland, Ann-Marie; Piette, John D

2010-03-01

We identify recent models for programmes aiming to increase effective family support for chronic illness management and self-care among adult patients without significant physical or cognitive disabilities. We then summarize evidence regarding the efficacy for each model identified. Structured review of studies published in medical and psychology databases from 1990 to the present, reference review, general Web searches and conversations with family intervention experts. Review was limited to studies on conditions that require ongoing self-management, such as diabetes, chronic heart disease and rheumatologic disease. Programmes with three separate foci were identified: (1) Programmes that guide family members in setting goals for supporting patient self-care behaviours have led to improved implementation of family support roles, but have mixed success improving patient outcomes. (2) Programmes that train family in supportive communication techniques, such as prompting patient coping techniques or use of autonomy supportive statements, have successfully improved patient symptom management and health behaviours. (3) Programmes that give families tools and infrastructure to assist in monitoring clinical symptoms and medications are being conducted, with no evidence to date on their impact on patient outcomes. The next generation of programmes to improve family support for chronic disease management incorporate a variety of strategies. Future research can define optimal clinical situations for family support programmes, the most effective combinations of support strategies, and how best to integrate family support programmes into comprehensive models of chronic disease care.

Emerging Models for Mobilizing Family Support for Chronic Disease Management: A Structured Review

PubMed Central

Rosland, Ann-Marie; Piette, John D.

2015-01-01

Objectives We identify recent models for programs aiming to increase effective family support for chronic illness management and self-care among adult patients without significant physical or cognitive disabilities. We then summarize evidence regarding the efficacy for each model identified. Methods Structured review of studies published in medical and psychology databases from 1990 to the present, reference review, general Web searches, and conversations with family intervention experts. Review was limited to studies on conditions that require ongoing self-management, such as diabetes, chronic heart disease, and rheumatologic disease. Results Programs with three separate foci were identified: 1) Programs that guide family members in setting goals for supporting patient self-care behaviors have led to improved implementation of family support roles, but have mixed success improving patient outcomes. 2) Programs that train family in supportive communication techniques, such as prompting patient coping techniques or use of autonomy supportive statements, have successfully improved patient symptom management and health behaviors. 3) Programs that give families tools and infrastructure to assist in monitoring clinical symptoms and medications are being conducted, with no evidence to date on their impact on patient outcomes. Discussion The next generation of programs to improve family support for chronic disease management incorporate a variety of strategies. Future research can define optimal clinical situations for family support programs, the most effective combinations of support strategies, and how best to integrate family support programs into comprehensive models of chronic disease care. PMID:20308347

24 CFR 583.235 - Renewal grants.

Code of Federal Regulations, 2014 CFR

2014-04-01

... as in effect before October 28, 1992, may be renewed on a noncompetitive basis to continue ongoing leasing, operations, and supportive services for additional years beyond the initial funding period. To be considered for renewal funding for leasing, operating costs, or supportive services, recipients must submit a...

24 CFR 583.235 - Renewal grants.

Code of Federal Regulations, 2011 CFR

2011-04-01

... as in effect before October 28, 1992, may be renewed on a noncompetitive basis to continue ongoing leasing, operations, and supportive services for additional years beyond the initial funding period. To be considered for renewal funding for leasing, operating costs, or supportive services, recipients must submit a...

Long-Term Impacts Faced by Patients and Families After Harmful Healthcare Events.

PubMed

Ottosen, Madelene J; Sedlock, Emily W; Aigbe, Aitebureme O; Bell, Sigall K; Gallagher, Thomas H; Thomas, Eric J

2018-01-17

Patients and families report experiencing a multitude of harms from medical errors resulting in physical, emotional, and financial hardships. Little is known about the duration and nature of these harms and the type of support needed to promote patient and family healing after such events. We sought to describe the long-term impacts (LTIs) reported by patients and family members who experienced harmful medical events 5 or more years ago. We performed a content analysis on 32 interviews originally conducted with 72 patients or family members about their views of the factors contributing to their self-reported harmful event. Interviews selected occurred 5 or more years after the harmful event and were grouped by time since event, 5 to 9 years (22 interviews) or 10 or more years (10 interviews) for analysis. We analyzed these interviews targeting spontaneous references of ongoing impacts experienced by the participants. Participants collectively described the following four LTIs: psychological, social/behavioral, physical, and financial. Most cited psychological impacts with half-reporting ongoing anger and vivid memories. More than half reported ongoing physical impacts and one-third experienced ongoing financial impacts. Long-term social and behavioral impacts such as alterations in lifestyle, self-identity, and healthcare seeking behaviors were the most highly reported. These patients and families experienced many profound LTIs after their harmful medical event. For some, these impacts evolved into secondary harms ongoing 10 years and more after the event. Our results draw attention to the persistent impacts patients and families may experience long after harmful events and the need for future research to understand and support affected patients and families.

Establishing Evidence-Based Indications for Proton Therapy: An Overview of Current Clinical Trials

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mishra, Mark V., E-mail: mmishra@umm.edu; Aggarwal, Sameer; Bentzen, Soren M.

Purpose: To review and assess ongoing proton beam therapy (PBT) clinical trials and to identify major gaps. Methods and Materials: Active PBT clinical trials were identified from (clinicaltrials.gov) and the World Health Organization International Clinical Trials Platform Registry. Data on clinical trial disease site, age group, projected patient enrollment, expected start and end dates, study type, and funding source were extracted. Results: A total of 122 active PBT clinical trials were identified, with target enrollment of >42,000 patients worldwide. Ninety-six trials (79%), with a median planned sample size of 68, were classified as interventional studies. Observational studies accounted for 21% ofmore » trials but 71% (n=29,852) of planned patient enrollment. The most common PBT clinical trials focus on gastrointestinal tract tumors (21%, n=26), tumors of the central nervous system (15%, n=18), and prostate cancer (12%, n=15). Five active studies (lung, esophagus, head and neck, prostate, breast) will randomize patients between protons and photons, and 3 will randomize patients between protons and carbon ion therapy. Conclusions: The PBT clinical trial portfolio is expanding rapidly. Although the majority of ongoing studies are interventional, the majority of patients will be accrued to observational studies. Future efforts should focus on strategies to encourage optimal patient enrollment and retention, with an emphasis on randomized, controlled trials, which will require support from third-party payers. Results of ongoing PBT studies should be evaluated in terms of comparative effectiveness, as well as incremental effectiveness and value offered by PBT in comparison with conventional radiation modalities.« less

Sustained and full fetal hemoglobin production after failure of bone marrow transplant in a patient homozygous for beta 0-thalassemia: a clinical remission despite genetic disease and transplant rejection.

PubMed

Paciaroni, Katia; Gallucci, Cristiano; De Angelis, Gioia; Alfieri, Cecilia; Roveda, Andrea; Lucarelli, Guido

2009-06-01

An adult patient affected by beta(0)-thalassemia major underwent allogeneic bone marrow transplant (BMT) from a matched related donor. Forty days after transplant, allogeneic engraftment failure and autologous beta(0)-thalassemic bone marrow recovery were documented. Red blood cell transfusions were required until 118 days post-transplant. Thereafter, the haemoglobin (Hb) levels stabilized over 11.8 gr/dl throughout the ongoing 34-month follow-up, abolishing the need for transfusion support. The Hb electrophoresis showed 100% Hb Fetal (HbF). This unexplained case suggests full HbF production may occur in an adult patient with beta(0)-thalassemia major.

Author-based journal selection system that helps authors save time in article submission.

PubMed

Ozturk, Onur; Ileri, Fatih

2018-01-01

Submission to journals takes a lot of time and format related submission requirements vary greatly from one journal to another. Lack of time and motivation in academia reduces scientific outputs and demotivates researchers. Author-based journal selection system (ABJSS) is a platform for pooling manuscripts conceived to minimize the time spent for manuscript submission and to increase scientific output. The system will provide two types of account: "Author" and "Journal Administrator". Each account type will have its own abilities and permissions. The ABJJS system is an ongoing project that will be designed in cooperation with IT experts and academicians and it will be presented to the scientific world as soon as it secures sufficient support.

Nurse faculty experiences in problem-based learning: an interpretive phenomenologic analysis.

PubMed

Paige, Jane B; Smith, Regina O

2013-01-01

This study explored the nurse faculty experience of participating in a problem-based learning (PBL) faculty development program. Utilizing PBL as a pedagogical method requires a paradigm shift in the way faculty think about teaching, learning, and the teacher-student relationship. An interpretive phenomenological analysis approach was used to explore the faculty experience in a PBL development program. Four themes emerged: change in perception of the teacher-student relationship, struggle in letting go, uncertainty, and valuing PBL as a developmental process. Epistemic doubt happens when action and intent toward the PBL teaching perspective do not match underlying beliefs. Findings from this study call for ongoing administrative support for education on PBL while faculty take time to uncover hidden epistemological beliefs.

Thermodynamic analysis and subscale modeling of space-based orbit transfer vehicle cryogenic propellant resupply

NASA Technical Reports Server (NTRS)

Defelice, David M.; Aydelott, John C.

1987-01-01

The resupply of the cryogenic propellants is an enabling technology for spacebased orbit transfer vehicles. As part of the NASA Lewis ongoing efforts in microgravity fluid management, thermodynamic analysis and subscale modeling techniques were developed to support an on-orbit test bed for cryogenic fluid management technologies. Analytical results have shown that subscale experimental modeling of liquid resupply can be used to validate analytical models when the appropriate target temperature is selected to relate the model to its prototype system. Further analyses were used to develop a thermodynamic model of the tank chilldown process which is required prior to the no-vent fill operation. These efforts were incorporated into two FORTRAN programs which were used to present preliminary analyticl results.

NGDS Final Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Blackman, Harold; Moore, Joseph

2014-06-30

The ultimate goal of the National Geothermal Data System (NGDS) is to support the discovery and generation of geothermal sources of energy. The NGDS was designed and has been implemented to provide online access to important geothermal-related data from a network of data providers in order to: • Increase the efficiency of exploration, development and usage of geothermal energy by providing a basis for financial risk analysis of potential sites • Assist state and federal agencies in making land and resource management assessments • Foster the discovery of new geothermal resources by supporting ongoing and future geothermal-related research • Increasemore » public awareness of geothermal energy It is through the implementation of this distributed data system and its subsequent use that substantial increases to the general access and understanding of geothermal related data will result. NGDS provides a mechanism for the sharing of data thereby fostering the discovery of new resources and supporting ongoing geothermal research.« less

The role of inter-professional relationships and support for nurse prescribing in acute and chronic pain.

PubMed

Stenner, Karen; Courtenay, Molly

2008-08-01

This paper is a report of a study to explore nurse prescribers' views on the role of inter-professional relationships and other means of support for nurse prescribing for patients in acute and chronic pain. Research indicates that good team relationships are important for supporting nurse prescribing but that poor understanding of the role by other healthcare professionals can act as a barrier. While collaborative working is central to the role of pain nurses, there is a lack of research on the impact of nurse prescribing on inter-professional working or the support needs of these nurses. A qualitative approach was adopted using thematic analysis of semi-structured interview data collected during 2006 and 2007. Participants were 26 nurses who prescribed medicines for patients with acute and/or chronic pain. Nurses' believed that prescribing encouraged collaborative working and sharing of knowledge across professional boundaries and that this helped to broaden understanding of the wider remit of pain management. Collaboration with doctors served a number of functions, including support and continuous learning. Barriers to effective nurse prescribing were a lack of understanding of its role amongst healthcare professionals and inadequate support. Formal support structures, such as regular clinical supervision, were seen as crucial to meeting nurses' ongoing learning. Factors that promote understanding of nurse prescribing and support inter-professional relationships are likely to have a positive impact on the effectiveness of nurse prescribing. A more consistent approach is required within organisations to support nurse prescribing.

How Can Innovative Learning Environments Promote the Diffusion of Innovation?

ERIC Educational Resources Information Center

Osborne, Mark

2016-01-01

Schools implementing innovative learning environments (ILEs) face many challenges, including the need to discard previously cherished practices and behaviours, adjust mindsets, and invent successful new ways of operating. Leaders can support these processes by implementing structures that: i) support ongoing, distributed, participatory innovation;…

DEVELOPMENT OF A DECISION SUPPORT FRAMEWORK FOR PLACEMENT OF BMPS IN URBAN-WATERSHEDS

EPA Science Inventory

This paper will present an on-going development of an integrated decision support framework (IDSF) for cost-effective placement of best management practices (BMPs) for managing wet weather flows (WWF) in urban watersheds. This decision tool will facilitate the selection and plac...

AN INTEGRATED DECISION SUPPORT FRAMEWORK FOR PLACEMENT OF BMPS IN URBAN-WATERSHEDS

EPA Science Inventory

This paper will present an on-going development of an integrated decision support framework (IDSF) for cost-effective placement of best management practices (BMPs) for managing wet weather flows (WWF) in urban watersheds. This decision tool will facilitate the selection and plac...

Ongoing Development of a Series Bosch Reactor System

NASA Technical Reports Server (NTRS)

Abney, Morgan; Mansell, Matt; DuMez, Sam; Thomas, John; Cooper, Charlie; Long, David

2013-01-01

Future manned missions to deep space or planetary surfaces will undoubtedly require highly robust, efficient, and regenerable life support systems that require minimal consumables. To meet this requirement, NASA continues to explore a Bosch-based carbon dioxide reduction system to recover oxygen from CO2. In order to improve the equivalent system mass of Bosch systems, we seek to design and test a "Series Bosch" system in which two reactors in series are optimized for the two steps of the reaction, as well as to explore the use of in situ materials as carbon deposition catalysts. Here we report recent developments in this effort including assembly and initial testing of a Reverse Water-Gas Shift reactor (RWGSr) and initial testing of two gas separation membranes. The RWGSr was sized to reduce CO2 produced by a crew of four to carbon monoxide as the first stage in a Series Bosch system. The gas separation membranes, necessary to recycle unreacted hydrogen and CO2, were similarly sized. Additionally, we report results of preliminary experiments designed to determine the catalytic properties of Martian and Lunar regolith simulant for the carbon deposition step.

Evaluation of advanced propulsion options for the next manned transportation system: Propulsion evolution study

NASA Technical Reports Server (NTRS)

Spears, L. T.; Kramer, R. D.

1990-01-01

The objectives were to examine launch vehicle applications and propulsion requirements for potential future manned space transportation systems and to support planning toward the evolution of Space Shuttle Main Engine (SSME) and Space Transportation Main Engine (STME) engines beyond their current or initial launch vehicle applications. As a basis for examinations of potential future manned launch vehicle applications, we used three classes of manned space transportation concepts currently under study: Space Transportation System Evolution, Personal Launch System (PLS), and Advanced Manned Launch System (AMLS). Tasks included studies of launch vehicle applications and requirements for hydrogen-oxygen rocket engines; the development of suggestions for STME engine evolution beyond the mid-1990's; the development of suggestions for STME evolution beyond the Advanced Launch System (ALS) application; the study of booster propulsion options, including LOX-Hydrocarbon options; the analysis of the prospects and requirements for utilization of a single engine configuration over the full range of vehicle applications, including manned vehicles plus ALS and Shuttle C; and a brief review of on-going and planned LOX-Hydrogen propulsion technology activities.

Summary Report for the Evaluation of Current QA Processes Within the FRMAC FAL and EPA MERL.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shanks, Sonoya T.; Redding, Ted; Jaussi, Lynn

The Federal Radiological Monitoring and Assessment Center (FRMAC) relies on accurate and defensible analytical laboratory data to support its mission. Therefore, FRMAC must ensure that the environmental analytical laboratories providing analytical services maintain an ongoing capability to provide accurate analytical results to DOE. It is undeniable that the more Quality Assurance (QA) and Quality Control (QC) measures required of the laboratory, the less resources that are available for analysis of response samples. Being that QA and QC measures in general are understood to comprise a major effort related to a laboratory’s operations, requirements should only be considered if they aremore » deemed “value-added” for the FRMAC mission. This report provides observations of areas for improvement and potential interoperability opportunities in the areas of Batch Quality Control Requirements, Written Communications, Data Review Processes, Data Reporting Processes, along with the lessons learned as they apply to items in the early phase of a response that will be critical for developing a more efficient, integrated response for future interactions between the FRMAC and EPA assets.« less

The Belle-II Depfet Pixel Detector at the Superkekb Flavour Factory

NASA Astrophysics Data System (ADS)

Heindl, Stefan

2012-08-01

The ongoing upgrade of the asymmetric electron positron collider KEKB also requires extensive detector upgrades to cope with the new design luminosity of 8 · 1035 cm-2 · s-1 · Of critical importance is the new silicon pixel vertex tracker, which will significantly improve the decay vertex resolution, crucial for time dependent CP violation measurements. This new detector will consist of two layers of DEPFET pixel seii8ors very close to the interaction point. These sensors combine both particle detection and amplification of the signal by embedding a field effect transistor into a 75 μm thick fully depleted silicon substrate, providing very high signal to noise ratios and excellent spatial resolution. Using this technology satisfies the given requirements of extremely low material and high radiation tolerance at the new Belle II experiment. The power dissipation due to continuous readout at high rate and spatial constraints also give strict requirements for the mechanical support and cooling of the new detector. We will discuss the overall concept of the pixel vertex tracker, its expected performance and the challenging mechanical integration.

Aircraft interrogation and display system: A ground support equipment for digital flight systems

NASA Technical Reports Server (NTRS)

Glover, R. D.

1982-01-01

A microprocessor-based general purpose ground support equipment for electronic systems was developed. The hardware and software are designed to permit diverse applications in support of aircraft flight systems and simulation facilities. The implementation of the hardware, the structure of the software, describes the application of the system to an ongoing research aircraft project are described.

Promoting the Development of a Supportive Learning Environment through Action Research from the "Middle Out"

ERIC Educational Resources Information Center

Hodgson, David; May, Steve; Marks-Maran, Diane

2008-01-01

This paper reports on a case study of a supportive learning environment initiative (SLEI) for students on health and social care undergraduate programmes in one English university. It involved the development of small scale support projects that are firmly grounded in the outcomes of prior research as well as the ongoing experience of students and…

Ebola virus disease and Marburg disease in pregnancy: a review and management considerations for filovirus infection.

PubMed

Bebell, Lisa M; Riley, Laura E

2015-06-01

The largest-ever recorded outbreak of viral hemorrhagic fever is ongoing. As a result of the epidemic and rural nature of outbreaks, little is published about the Filovirus infections Ebola virus disease and Marburg disease in pregnancy. This review of viral hemorrhagic fever focusing on Marburg and Ebola uses knowledge of disease in nonpregnant individuals and pregnancy-specific data to inform management for pregnant women. Filovirus infection presentation is similar between pregnant and nonpregnant patients, although infections may be more severe in pregnancy. Although labeled as hemorrhagic fevers, Marburg and Ebola do not commonly cause gross bleeding and should be conceptualized as diseases of high gastrointestinal losses. Early, aggressive supportive care is the mainstay of Filovirus infection management with massive fluid resuscitation as the key management principle. Patients often require 5-10 L or more per day of intravenous or oral fluid to maintain circulating blood volume in the setting of ongoing gastrointestinal loss. Fluid shifts warrant aggressive monitoring and correction of potassium levels and acid-base disturbances to prevent life-threatening arrhythmias and metabolic complications. Regardless of maternal survival, fetal loss rates are nearly 100% in Filovirus infection, likely resulting from unchecked transplacental and hematogenous viral spread. High fetal loss rates support the placenta as a difficult-to-eradicate Filovirus infection reservoir. In conclusion, the management of Filovirus infection in pregnancy should focus on stabilizing the mother with intensive monitoring and aggressive fluid and electrolyte repletion as well as maintaining strict infection control to minimize transmission to others.

A qualitative study of patient experiences of Type 2 Diabetes care delivered comparatively by General Practice Nurses and Medical Practitioners.

PubMed

Boyle, Eileen; Saunders, Rosemary; Drury, Vicki

2016-07-01

To explore patient experiences of type 2 diabetes mellitus care delivered by general practice nurses in collaboration with the general practitioner. Australian general practice nurses are expanding their role in multidisciplinary type 2 diabetes care with limited research on patient perceptions of care provision within this collaborative model. Qualitative interpretive. Purposeful sampling was used to invite the patients (n = 10). Data were collected from semi-structured face-to-face interviews. Braun and Clarke's () inductive coding thematic analysis process was used to interpret the data. All participants experienced their General Practice Nurse consultation as a clinical assessment for their General Practitioner. While they appreciated the extra time with the General Practice Nurse, they were unsure of the purpose of the consultation beyond clinical assessment. They described the ongoing challenge of living with T2DM and identified a need for additional information and advice. The results suggest that the model of general practice nurse type 2 diabetes care has an important role to play in the delivery of effective ongoing care of patients. However, this role requires further development to ensure that it is understood by the patients as a role that not only conducts clinical assessments but also provides relevant education and self-management support as part of a collaborative approach to care delivery with General Practitioners. The findings are relevant to primary health care clinicians providing diabetes care to inform more relevant supportive care by general practice nurses. © 2016 John Wiley & Sons Ltd.

The MCH navigator: tools for MCH workforce development and lifelong learning.

PubMed

Grason, Holly; Huebner, Colleen; Crawford, Alyssa Kim; Ruderman, Marjory; Taylor, Cathy R; Kavanagh, Laura; Farel, Anita; Wightkin, Joan; Long-White, Deneen; Ramirez, Shokufeh M; Preskitt, Julie; Morrissette, Meredith; Handler, Arden

2015-02-01

Maternal and child health (MCH) leadership requires an understanding of MCH populations and systems as well as continuous pursuit of new knowledge and skills. This paper describes the development, structure, and implementation of the MCH Navigator, a web-based portal for ongoing education and training for a diverse MCH workforce. Early development of the portal focused on organizing high quality, free, web-based learning opportunities that support established learning competencies without duplicating existing resources. An academic-practice workgroup developed a conceptual model based on the MCH Leadership Competencies, the Core Competencies for Public Health Professionals, and a structured review of MCH job responsibilities. The workgroup used a multi-step process to cull the hundreds of relevant, but widely scattered, trainings and select those most valuable for the primary target audiences of state and local MCH professionals and programs. The MCH Navigator now features 248 learning opportunities, with additional tools to support their use. Formative assessment findings indicate that the portal is widely used and valued by its primary audiences, and promotes both an individual's professional development and an organizational culture of continuous learning. Professionals in practice and academic settings are using the MCH Navigator for orientation of new staff and advisors, "just in time" training for specific job functions, creating individualized professional development plans, and supplementing course content. To achieve its intended impact and ensure the timeliness and quality of the Navigator's content and functions, the MCH Navigator will need to be sustained through ongoing partnership with state and local MCH professionals and the MCH academic community.

Implementation of a personnel reliability program as a facilitator of biosafety and biosecurity culture in BSL-3 and BSL-4 laboratories.

PubMed

Higgins, Jacki J; Weaver, Patrick; Fitch, J Patrick; Johnson, Barbara; Pearl, R Marene

2013-06-01

In late 2010, the National Biodefense Analysis and Countermeasures Center (NBACC) implemented a Personnel Reliability Program (PRP) with the goal of enabling active participation by its staff to drive and improve the biosafety and biosecurity culture at the organization. A philosophical keystone for accomplishment of NBACC's scientific mission is simultaneous excellence in operations and outreach. Its personnel reliability program builds on this approach to: (1) enable and support a culture of responsibility based on human performance principles, (2) maintain compliance with regulations, and (3) address the risk associated with the insider threat. Recently, the Code of Federal Regulations (CFR) governing use and possession of biological select agents and toxins (BSAT) was amended to require a pre-access suitability assessment and ongoing evaluation for staff accessing Tier 1 BSAT. These 2 new requirements are in addition to the already required Federal Bureau of Investigation (FBI) Security Risk Assessment (SRA). Two years prior to the release of these guidelines, NBACC developed its PRP to supplement the SRA requirement as a means to empower personnel and foster an operational environment where any and all work with BSAT is conducted in a safe, secure, and reliable manner.

The impact of evidence-based practice implementation and fidelity monitoring on staff turnover: evidence for a protective effect.

PubMed

Aarons, Gregory A; Sommerfeld, David H; Hecht, Debra B; Silovsky, Jane F; Chaffin, Mark J

2009-04-01

Staff retention is an ongoing challenge in mental health and community-based service organizations. Little is known about the impact of evidence-based practice implementation on the mental health and social service workforce. The present study examined the effect of evidence-based practice implementation and ongoing fidelity monitoring on staff retention in a children's services system. The study took place in the context of a statewide, regionally randomized effectiveness trial of an evidence-based intervention designed to reduce child neglect. In the study 21 teams consisting of 153 home-based service providers were followed over a 29-month period. Survival analyses revealed greater staff retention in the condition where the evidence-based practice was implemented along with ongoing fidelity monitoring presented to staff as supportive consultation. These results should help to allay concerns about staff retention when implementing evidence-based practices where there is good values-innovation fit and when fidelity monitoring is designed as an aid and support to service providers in providing a high standard of care for children and families.

The Impact of Evidence-Based Practice Implementation and Fidelity Monitoring on Staff Turnover: Evidence for a Protective Effect

PubMed Central

Aarons, Gregory A.; Sommerfeld, David H.; Hecht, Debra B.; Silovsky, Jane F.; Chaffin, Mark J.

2009-01-01

Staff retention is an ongoing challenge in mental health and community-based service organizations. Little is known about the impact of evidence-based practice implementation on the mental health and social service workforce. The present study examined the effect of evidence-based practice implementation and ongoing fidelity monitoring on staff retention in a children’s services system. The study took place in the context of a statewide regionally randomized effectiveness trial of an evidence-based intervention designed to reduce child neglect. Twenty-one teams consisting of 153 home-based service providers were followed over a 29 month period. Survival analyses revealed greater staff retention in the condition where the evidence-based practice was implemented along with ongoing fidelity monitoring presented to staff as supportive consultation. These results should help to allay concerns about staff retention when implementing evidence-based practices where there is good values-innovation fit and when fidelity monitoring is designed as an aid and support to service providers in providing a high standard of care for children and families. PMID:19309186

Towards a virtual health record for mobile home care of elderly citizens.

PubMed

Koch, Sabine; Hägglund, Maria; Scandurra, Isabella; Moström, Dennis

2004-01-01

Mobile work situations within home care of the elderly require immediate and ubiquitous access to patient-oriented data. The ongoing Swedish research project "Technical support for Mobile CloseCare" focuses on the development and evaluation of work-scenario oriented ICT support for enhanced home care of elderly citizens. The aim of the project is to provide a seamless and consistent information flow between different health care providers and to give intuitive access to information services for the elderly and their relatives. For that purpose, different independent software components are connected through a mobile communication platform. Flexible access to prioritized information for different users in different work situations will be given through a virtual health record. In order to obtain both usable and clinically relevant results, a user centered system development approach is followed. Evaluation of the project results will be based on usability tests and quasi-experimental studies on how system implementation influences quality of care and job- and life satisfaction for care providers, patients and relatives.

Clinical Nursing Leadership Education in Long-Term Care: Intervention Design and Evaluation.

PubMed

Fiset, Valerie; Luciani, Tracy; Hurtubise, Alyssa; Grant, Theresa L

2017-04-01

The main objective of the current case study was to investigate the perceived leadership learning needs and feasibility of delivering leadership education to registered staff involved in direct care in long-term care (LTC) homes. The study was conducted in Ontario, Canada, and participants included RNs, registered practical nurses, and nursing administrators. Phase 1 bilingual web-based survey and bilingual focus group needs assessment data supported a preference for external training along with in-house mentoring to support sustainability. An intervention designed using insights gained from Phase 1 data was delivered via a 2-day, in-person workshop. Phases 2 and 3 evaluation survey data identified aspects of leadership training for LTC that require ongoing refinement. Findings suggest that communication skills and managing day-to-day nursing demands in the context of regulatory frameworks were areas of particular interest for leadership training in the LTC setting. [Journal of Gerontological Nursing, 43(4), 49-56.]. Copyright 2017, SLACK Incorporated.

Role for Automated Communication Strategies in Medication Adherence Management

PubMed Central

Ross, S. Michael

2008-01-01

Lack of medication adherence is a prevalent problem that causes a broad range of health-and health-economics-related issues. Adherence management is therefore an important strategy, but it also presents its own set of challenges. Interventional communication from care support teams at managed care organizations and disease management and wellness programs has proved effective at modifying patients' medication adherence and reporting behaviors. However, these communications do not work well from an economic standpoint. It is not economically feasible to scale call centers and the numbers of clinical and professional staff to communicate with the increasing number of patients with chronic diseases who require ongoing medication use. Using communication automation to augment traditional call center outreach can help to mediate patient medication-taking behaviors. Specific design criteria for the automation of this interaction are discussed in this article, offering supporting data from a recent trial of 304 elderly patients with hypertension, and showing the benefits of using such a system for effective blood pressure monitoring, at reduced costs. PMID:25126263

Role for automated communication strategies in medication adherence management.

PubMed

Ross, S Michael

2008-11-01

Lack of medication adherence is a prevalent problem that causes a broad range of health-and health-economics-related issues. Adherence management is therefore an important strategy, but it also presents its own set of challenges. Interventional communication from care support teams at managed care organizations and disease management and wellness programs has proved effective at modifying patients' medication adherence and reporting behaviors. However, these communications do not work well from an economic standpoint. It is not economically feasible to scale call centers and the numbers of clinical and professional staff to communicate with the increasing number of patients with chronic diseases who require ongoing medication use. Using communication automation to augment traditional call center outreach can help to mediate patient medication-taking behaviors. Specific design criteria for the automation of this interaction are discussed in this article, offering supporting data from a recent trial of 304 elderly patients with hypertension, and showing the benefits of using such a system for effective blood pressure monitoring, at reduced costs.

Should Lecture Recordings Be Mandated in Dental Schools? Two Viewpoints: Viewpoint 1: Lecture Recordings Should Be Mandatory in U.S. Dental Schools and Viewpoint 2: Lecture Recordings Should Not Be Mandatory in U.S. Dental Schools.

PubMed

Zandona, Andrea Ferreira; Kinney, Janet; Seong, WookJin; Kumar, Vandana; Bendayan, Alexander; Hewlett, Edmond

2016-12-01

Transcription or recording of lectures has been in use for many years, and with the availability of high-fidelity recording, the practice is now ubiquitous in higher education. Since technology has permeated education and today's tech-savvy students have expectations for on-demand learning, dental schools are motivated to record lectures, albeit with positive and negative implications. This Point/Counterpoint article addresses the question of whether lecture recording should be mandatory in U.S. dental schools. Viewpoint 1 supports the statement that lecture recording should be mandatory. Proponents of this viewpoint argue that the benefits-notably, student satisfaction and potential for improvement in student performance-outweigh concerns. Viewpoint 2 takes the opposite position, arguing that lecture recording decreases students' classroom attendance and adversely affects the morale of educators. Additional arguments against mandatory lecture recordings involve the expense of incorporating technology that requires ongoing support.

Underground Test Area Activity Preemptive Review Guidance Nevada National Security Site, Nevada, Revision 0

DOE Office of Scientific and Technical Information (OSTI.GOV)

Farnham, Irene; Rehfeldt, Kenneth

Preemptive reviews (PERs) of Underground Test Area (UGTA) Activity corrective action unit (CAU) studies are an important and long-maintained quality improvement process. The CAU-specific PER committees provide internal technical review of ongoing work throughout the CAU lifecycle. The reviews, identified in the UGTA Quality Assurance Plan (QAP) (Sections 1.3.5.1 and 3.2), assure work is comprehensive, accurate, in keeping with the state of the art, and consistent with CAU goals. PER committees review various products, including data, documents, software/codes, analyses, and models. PER committees may also review technical briefings including Federal Facility Agreement and Consent Order (FFACO)-required presentations to the Nevadamore » Division of Environmental Protection (NDEP) and presentations supporting key technical decisions (e.g., investigation plans and approaches). PER committees provide technical recommendations to support regulatory decisions that are the responsibility of the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Field Office (NNSA/NFO) and NDEP.« less

Impact of four training conditions on physician use of a web-based clinical decision support system.

PubMed

Kealey, Edith; Leckman-Westin, Emily; Finnerty, Molly T

2013-09-01

Training has been identified as an important barrier to implementation of clinical decision support systems (CDSSs), but little is known about the effectiveness of different training approaches. Using an observational retrospective cohort design, we examined the impact of four training conditions on physician use of a CDSS: (1) computer lab training with individualized follow-up (CL-FU) (n=40), (2) computer lab training without follow-up (CL) (n=177), (3) lecture demonstration (LD) (n=16), or (4) no training (NT) (n=134). Odds ratios of any use and ongoing use under training conditions were compared to no training over a 2-year follow-up period. CL-FU was associated with the highest percent of active users and odds for any use (90.0%, odds ratio (OR)=10.2, 95% confidence interval (CI): 3.2-32.9) and ongoing use (60.0%, OR=6.1 95% CI: 2.6-13.7), followed by CL (any use=81.4%, OR=5.3, CI: 2.9-9.6; ongoing use=28.8%, OR=1.7, 95% CI: 1.0-3.0). LD was not superior to no training (any use=47%, ongoing use=22.4%). Training format may have differential effects on initial and long-term follow-up of CDSSs use by physicians. Copyright © 2013 Elsevier B.V. All rights reserved.

A randomized double-blinded controlled trial of hCG as luteal phase support in natural cycle frozen embryo transfer.

PubMed

Lee, Vivian Chi Yan; Li, Raymond Hang Wun; Yeung, William Shu Biu; Pak Chung, H O; Ng, Ernest Hung Yu

2017-05-01

Does the use of hCG as luteal phase support in natural cycle frozen embryo transfer (FET) increase the ongoing pregnancy rate? The use of hCG in natural cycle FET did not improve the ongoing pregnancy rate. The use of luteal phase support in stimulated cycles has been associated with higher live-birth rates and the results are similar when using hCG or progesterone. This is a randomized double-blinded controlled trial of 450 women recruited between August 2013 and October 2015. Women with regular cycles undergoing natural cycle FET were recruited. Serial serum hormonal concentrations were used to time natural ovulation and at least Day 2 cleavage embryos were replaced. Patients were randomized into either: (i) the treatment group, receiving 1500 IU hCG on the day of FET and 6 days after FET, or (ii) the control group, receiving normal saline on these 2 days. The ongoing pregnancy rate [60/225 (26.7%) in the treatment group vs 70/225 (31.3%) in the control group, odds ratio 1.242 (95% CI 0.825-1.869)], implantation rate and miscarriage rate were comparable between the two groups. In the treatment group, there were significantly more cycles with top quality embryos transferred and a significantly higher serum oestradiol level, but a comparable serum progesterone level, 6 days after FET. However, no significant differences were observed in serum oestradiol and progesterone levels 6 days after FET between the pregnant and non-pregnant women. In the multivariate logistic regression, the number of embryos transferred was the only significant factor predictive of the ongoing pregnancy rate after natural cycle FET. This study only included FET with cleavage stage embryos and only hCG, not vaginal progesterone, was used as luteal phase support. The findings in this study do not support the use of hCG for luteal phase support in natural cycle FET. No external funding was used and there were no competing interests. clinicaltrial.gov identifier: NCT01931384. 23/8/2013. 30/8/2013. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Ongoing training of community health workers in low-income andmiddle-income countries: a systematic scoping review of the literature.

PubMed

O'Donovan, James; O'Donovan, Charles; Kuhn, Isla; Sachs, Sonia Ehrlich; Winters, Niall

2018-04-28

Understanding the current landscape of ongoing training for community health workers (CHWs) in low-income and middle-income countries (LMICs) is important both for organisations responsible for their training, as well as researchers and policy makers. This scoping review explores this under-researched area by mapping the current delivery implementation and evaluation of ongoing training provision for CHWs in LMICs. Systematic scoping review. MEDLINE, Embase, AMED, Global Health, Web of Science, Scopus, ASSIA, LILACS, BEI and ERIC. Original studies focusing on the provision of ongoing training for CHWs working in a country defined as low income and middle income according to World Bank Group 2012 classification of economies. The scoping review found 35 original studies that met the inclusion criteria. Ongoing training activities for CHWs were described as supervision (n=19), inservice or refresher training (n=13) or a mixture of both (n=3). Although the majority of studies emphasised the importance of providing ongoing training, several studies reported no impact of ongoing training on performance indicators. The majority of ongoing training was delivered inperson; however, four studies reported the use of mobile technologies to support training delivery. The outcomes from ongoing training activities were measured and reported in different ways, including changes in behaviour, attitudes and practice measured in a quantitative manner (n=16), knowledge and skills (n=6), qualitative assessments (n=5) or a mixed methods approach combining one of the aforementioned modalities (n=8). This scoping review highlights the diverse range of ongoing training for CHWs in LMICs. Given the expansion of CHW programmes globally, more attention should be given to the design, delivery, monitoring and sustainability of ongoing training from a health systems strengthening perspective. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Supporting Tertiary Students with a Disability or Mental Illness. Good Practice Guide

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2015

2015-01-01

Having a disability or ongoing ill health (including mental health conditions) can significantly disrupt an individual's educational attainment and employment prospects, potentially creating lifelong social and economic disadvantage. These students may need additional support to help them successfully complete their studies. In addition, education…

A Relationship Marketing Approach to Academic Initiative Planning: A Case in Point

ERIC Educational Resources Information Center

Mobley, Mary F.; Basciano, Peter

2012-01-01

Many higher education initiatives are dependent upon the development of multiple relationships across academic and support functions. The probability of achieving superior initiative outcomes rests, in part, on the construction of an infrastructure that supports the goals, strategies, tactics, and ongoing mission of a defined project. Through…

Attachment Theory and Primary Caregiving

ERIC Educational Resources Information Center

Colmer, Kaye; Rutherford, Lynne; Murphy, Pam

2011-01-01

Offering intensive parent support programs within an early childhood setting recognises that early childhood educators are uniquely placed to form highly supportive and ongoing relationships with children and their families as part of their everyday work. This feature of early childhood programs can be utilised to include educators as partners in…

76 FR 41452 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-14

..., governance and well-being. Data to support some indicators for these measures are already routinely collected... this survey is to provide for the ongoing collection of social and economic data related to fisheries and their communities in the Northeast and Mid-Atlantic states. These data are needed to support...

Understanding, Evaluating, and Supporting Self-Regulated Learning Using Learning Analytics

ERIC Educational Resources Information Center

Roll, Ido; Winne, Philip H.

2015-01-01

Self-regulated learning is an ongoing process rather than a single snapshot in time. Naturally, the field of learning analytics, focusing on interactions and learning trajectories, offers exciting opportunities for analyzing and supporting self-regulated learning. This special section highlights the current state of research at the intersection of…

A Collaborative Professional Development Initiative Supporting Early Literacy Coaches

ERIC Educational Resources Information Center

Mraz, Maryann; Kissel, Brian; Algozzine, Bob; Babb, Julie; Foxworth, Kimberly

2011-01-01

Many believe that the key to translating research into successful practice lies in providing teachers with continuous professional development and ongoing coaching support. In this article, we provide an overview of the relevant coaching literature and describe 4 critical features of an evidence-based preschool literacy coaching model: the coach…

Near Real-Time Applications of Earth Remote Sensing for Response to Meteorological Disasters

NASA Technical Reports Server (NTRS)

Molthan, Andrew L.; Burks, Jason E.; McGrath, Kevin M.; Bell, Jordan R.

2013-01-01

Numerous on-orbit satellites provide a wide range of spatial, spectral, and temporal resolutions supporting the use of their resulting imagery in assessments of disasters that are meteorological in nature. This presentation will provide an overview of recent use of Earth remote sensing by NASA's Short-term Prediction Research and Transition (SPoRT) Center in response to disaster activities in 2012 and 2013, along with case studies supporting ongoing research and development. The SPoRT Center, with support from NASA's Applied Sciences Program, has explored a variety of new applications of Earth-observing sensors to support disaster response. In May 2013, the SPoRT Center developed unique power outage composites representing the first clear sky view of damage inflicted upon Moore and Oklahoma City, Oklahoma following the devastating EF-5 tornado that occurred on May 20. Subsequent ASTER, MODIS, Landsat-7 and Landsat-8 imagery help to identify the damaged area. Higher resolution imagery of Moore, Oklahoma were provided by commercial satellites and the recently available International Space Station (ISS) SERVIR Environmental Research and Visualization System (ISERV) instrument. New techniques are being explored by the SPoRT team in order to better identify damage visible in high resolution imagery, and to monitor ongoing recovery for Moore, Oklahoma. Other applications are being developed to refine light source detections with the VIIRS day-night band and to map hail during the growing season through combination of available satellite and radar imagery. The aforementioned products and support are not useful unless they are distributed in a timely manner and within an appropriate decision support system. This presentation will provide an update on ongoing activities to support inclusion of these data sets within the NOAA National Weather Service Damage Assessment Toolkit, which allows meteorologists in the field to consult available satellite imagery while performing their damage assessment.

Near Real-­Time Applications of Earth Remote Sensing for Response to Meteorological Disasters

NASA Technical Reports Server (NTRS)

Molthan, Andrew L.; Burks, Jason E.; McGrath, Kevin M.; Bell, Jordan R.

2013-01-01

Numerous on-orbit satellites provide a wide range of spatial, spectral, and temporal resolutions supporting the use of their resulting imagery in assessments of disasters that are meteorological in nature. This presentation will provide an overview of recent use of Earth remote sensing by NASA's Short-term Prediction Research and Transition (SPoRT) Center in response to disaster activities in 2012 and 2013, along with case studies supporting ongoing research and development. The SPoRT Center, with support from NASA's Applied Sciences Program, has explored a variety of new applications of Earth-observing sensors to support disaster response. In May 2013, the SPoRT Center developed unique power outage composites representing the first clear sky view of damage inflicted upon Moore and Oklahoma City, Oklahoma following the devastating EF-5 tornado that occurred on May 20. Subsequent ASTER, MODIS, Landsat-7 and Landsat-8 imagery help to identify the damaged area. Higher resolution imagery of Moore, Oklahoma were provided by commercial satellites and the recently available International Space Station (ISS) SERVIR Environmental Research and Visualization System (ISERV) instrument. New techniques are being explored by the SPoRT team in order to better identify damage visible in high resolution imagery, and to monitor ongoing recovery for Moore, Oklahoma. Other applications are being developed to refine light source detections with the VIIRS day-night band and to map hail during the growing season through combination of available satellite and radar imagery. The aforementioned products and support are not useful unless they are distributed in a timely manner and within an appropriate decision support system. This presentation will provide an update on ongoing activities to support inclusion of these data sets within the NOAA National Weather Service Damage Assessment Toolkit, which allows meteorologists in the field to consult available satellite imagery while performing their damage assessment.

Working with Persistent Pain: An Exploration of Strategies Utilised to Stay Productive at Work.

PubMed

Oakman, Jodi; Kinsman, Natasha; Briggs, Andrew M

2017-03-01

Purpose Maintaining productive employment for people with persistent pain conditions is challenging. This study aims to explore supports-work and non-work- used by employees to assist them in maintaining productive employment. Methods An exploratory, mixed-methods study comprising a questionnaire battery followed by semi-structured interviews to collect in-depth qualitative data was undertaken. The questionnaires measured descriptive variables used to select participants for interviews based on maximum heterogeneity sampling. Thirty-five semi-structured interviews were undertaken (14 males; 21 females). The interview schedule covered: employment situation, workplace challenges, workplace supports, coping strategies, motivations, future employment options and any other resources utilised. Inductive content analysis was undertaken using a grounded theory approach to systematically explore the data. Results Three key themes were identified: barriers to working productively, enablers to working productively, disclosing my condition at work. A key determinant of maintaining productive employment was a supportive employer. In addition, flexibility in the work organisation was also pivotal in maintaining sustainable, productive employment. An important issue emerged with regard to disclosure of one's condition to an employer. For some, this was a significant barrier to employment. Conclusions To ensure sustainable employment is attainable for those with persistent pain conditions, a good match is required between an employee and their work. Workplace accommodations may assist with improving job fit but this requires disclosure of a condition to an employer. Weighing up the risks and benefits of disclosure is difficult, and may be assisted by knowledge of available supports to assist with maintaining ongoing employment.

A care improvement program acting as a powerful learning environment to support nursing students learning facilitation competencies.

PubMed

Jukema, Jan S; Harps-Timmerman, Annelies; Stoopendaal, Annemiek; Smits, Carolien H M

2015-11-01

Change management is an important area of training in undergraduate nursing education. Successful change management in healthcare aimed at improving practices requires facilitation skills that support teams in attaining the desired change. Developing facilitation skills in nursing students requires formal educational support. A Dutch Regional Care Improvement Program based on a nationwide format of change management in healthcare was designed to act as a Powerful Learning Environment for nursing students developing competencies in facilitating change. This article has two aims: to provide comprehensive insight into the program components and to describe students' learning experiences in developing their facilitation skills. This Dutch Regional Care Improvement Program considers three aspects of a Powerful Learning Environment: self-regulated learning; problem-based learning; and complex, realistic and challenging learning tasks. These three aspects were operationalised in five distinct areas of facilitation: increasing awareness of the need for change; leadership and project management; relationship building and communication; importance of the local context; and ongoing monitoring and evaluation. Over a period of 18 months, 42 nursing students, supported by trained lecturer-coaches, took part in nine improvement teams in our Regional Care Improvement Program, executing activities in all five areas of facilitation. Based on the students' experiences, we propose refinements to various components of this program, aimed at strengthenin the learning environment. There is a need for further detailed empirical research to study the impact this kind of learning environment has on students developing facilitation competencies in healthcare improvement. Copyright © 2015 Elsevier Ltd. All rights reserved.

Should ongoing airway education be a mandatory component of continuing professional development for College of Intensive Care Medicine Fellows?

PubMed

Brewster, D J; Nickson, C P; Gatward, J J; Staples, M; Hawker, F

2018-03-01

This study aimed to determine whether airway education should be introduced to the continuing professional development (CPD) program for College of Intensive Care Medicine (CICM) Fellows. A random representative sample of 11 tertiary intensive care units (ICUs) was chosen from the list of 56 units accredited for 12 or 24 months of CICM training. All specialist intensive care Fellows (n=140) currently practising at the eleven ICUs were sent the questionnaire via email. Questionnaire data collection and post-collection data analysis was used to determine basic respondent demographics, frequency of certain airway procedures in the past 12 months, confidence with advanced airway practices in ICU, participation in airway education in the past three years, knowledge of can't intubate, can't oxygenate (CICO) algorithms, preference for certain airway equipment/techniques, and support for required airway education as a component of the CICM CPD program. All responses were tabled for comparison. Data was analysed to establish any significant effect of another specialty qualification and current co-practice in anaesthesia on volume of practice, confidence with multiple airway procedures, use of airway equipment, and support for airway education. In total, 112 responses (response rate 80%) to the questionnaire were received within four weeks; 107 were completed in full (compliance 96%). All results were tabled. There is currently widespread support amongst CICM Fellows for airway skills education as a CPD requirement for CICM Fellows. Volumes of practice and confidence levels with different airway procedures vary amongst Fellows and further support the need for education.

Sustained Professional Development on Cooperative Learning: Impact on Six Teachers' Practices and Students' Learning.

PubMed

Goodyear, Victoria A

2017-03-01

It has been argued, extensively and internationally, that sustained school-based continuous professional development (CPD) has the potential to overcome some of the shortcomings of traditional one-off CPD programs. Yet, the evidence base on more effective or less effective forms of CPD is contradictory. The mechanisms by which sustained support should be offered are unclear, and the impacts on teachers' and students' learning are complex and difficult to track. The purpose of this study was to examine the impact of a sustained school-based, tailored, and supported CPD program on teachers' practices and students' learning. Data are reported from 6 case studies of individual teachers engaged in a yearlong CPD program focused on cooperative learning. The CPD program involved participatory action research and frequent interaction/support from a boundary spanner (researcher/facilitator). Data were gathered from 29 video-recorded lessons, 108 interviews, and 35 field journal entries. (a) Individualized (external) support, (b) departmental (internal) support, and (c) sustained support impacted teachers' practices of cooperative learning. The teachers adapted their practices of cooperative learning in response to their students' learning needs. Teachers began to develop a level of pedagogical fluency, and in doing so, teachers advanced students' learning. Because this study demonstrates impact, it contributes to international literature on effective CPD. The key contribution is the detailed evidence about how and why CPD supported 6 individual teachers to learn-differently-and the complexity of the learning support required to engage in ongoing curriculum development to positively impact student learning.

45 CFR 2516.810 - What types of evaluations are grantees and subgrantees required to perform?

Code of Federal Regulations, 2010 CFR

2010-10-01

... Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE SCHOOL-BASED SERVICE-LEARNING PROGRAMS...? All grantees and subgrantees are required to perform internal evaluations which are ongoing efforts to assess performance and improve quality. Grantees and subgrantees may, but are not required to, arrange...

78 FR 38851 - Electric Reliability Organization Proposal To Retire Requirements in Reliability Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-28

... 215 of the Federal Power Act, the Commission proposes to approve the retirement of 34 requirements... of the Reliability Standards. In addition, the Commission proposes to withdraw 41 outstanding...-Power System. This proposal is part of the Commission's ongoing effort to review its requirements and...

The Validity of Two Education Requirement Measures

ERIC Educational Resources Information Center

van der Meer, Peter H.

2006-01-01

In this paper we investigate the validity of two education requirement measures. This is important because a key part of the ongoing discussion concerning overeducation is about measurement. Thanks to the Dutch Institute for Labour Studies, we have been given a unique opportunity to compare two education requirement measures: first, Huijgen's…

Struggles, strengths, and strategies: an ethnographic study exploring the experiences of adolescents living with an ostomy

PubMed Central

Nicholas, David B; Swan, Sylvia R; Gerstle, Ted J; Allan, Theresa; Griffiths, Anne Marie

2008-01-01

Background Adolescents with IBD requiring ostomy surgery experience perioperative needs that may exceed those of patients experiencing other major abdominal surgery [1]. This procedure requires ongoing and vigilant daily care and management. Gastrointestinal symptoms and complications impose psychological and social stresses on young patients [2], and the procedure results in body image changes and daily regimens of self-care. This study aimed to explore adolescents' experiences and quality of life following ostomy surgery. Methods Ethnographic interviews and a subsequent focus group were conducted with 20 adolescents with an ostomy or j-pouch being treated at the Hospital for Sick Children in Toronto, Canada. Interviews were transcribed verbatim and subjected to theme generation. Results Findings suggest that adolescents are profoundly affected by their ostomy. Adolescents convey strength as well as adjustment struggles. Identified impacts include body intrusion and body image changes, decreased independence, secrecy about the ostomy, adjustment over time, challenges for the family, and strategies for constructively moving forward. Conclusion Implications address the importance of ensuring meaningful opportunities to understand and reframe the stresses of illness. An ongoing clinical challenge involves the promotion of a healthy self-esteem and psychosocial adjustment for these adolescents and their families. Finding effective ways to minimize stress and embarrassment and reframe personal shame, constitute important clinical priorities. Opportunities for peer support and family dialogue may assist in clarifying worries and easing the burden carried by these young persons. Flexible and adequately funded resources are advocated in fostering quality of life. PMID:19091104

'It's trying to manage the work': a qualitative evaluation of recruitment processes within a UK multicentre trial.

PubMed

Skea, Zoë Christina; Treweek, Shaun; Gillies, Katie

2017-08-11

To explore trial site staff's perceptions regarding barriers and facilitators to local recruitment. Qualitative semi-structured interviews with a range of trial site staff from four trial sites in the UK. Interviews were analysed thematically to identify common themes across sites, barriers that could be addressed and facilitators that could be shared with other sites. 11 members of staff from four trial sites: clinical grant Co-applicant (n=1); Principal Investigators (n=3); Consultant Urologist (n=1); Research Nurses (n=5); Research Assistant (n=1). Embedded within an ongoing randomised controlled trial (the TISU trial). TISU is a UK multicentre trial comparing therapeutic interventions for ureteric stones. Our study draws attention to the initial and ongoing burden of trial work that is involved throughout the duration of a clinical trial. In terms of building and sustaining a research culture, trial staff described the ongoing work of engagement that was required to ensure that clinical staff were both educated and motivated to help with the process of identifying and screening potential participants. Having adequate and sufficient organisational and staffing resources was highlighted as being a necessary prerequisite to successful recruitment both in terms of accessing potentially eligible patients and being able to maximise recruitment after patient identification. The nature of the research study design can also potentially generate challenging communicative work for recruiting staff which can prove particularly problematic. Our paper adds to existing research highlighting the importance of the hidden and complex work that is involved in clinical trial recruitment. Those designing and supporting the operationalisation of clinical trials must recognise and support the mitigation of this 'work'. While much of the work is likely to be contextually sensitive at the level of local sites and for individual trials, some aspects are ubiquitous issues for delivery of trials more generally. ISRCTN No 92289221; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Substance abuse treatment management information systems: balancing federal, state, and service provider needs.

PubMed

Camp, J M; Krakow, M; McCarty, D; Argeriou, M

1992-01-01

There is increased interest in documenting the characteristics and treatment outcomes of clients served with Alcohol, Drug Abuse, and Mental Health Block Grant funds. The evolution of federal client-based management systems for substance abuse treatment services demonstrates that data collection systems are important but require continued support. A review of the Massachusetts substance abuse management information system illustrates the utility of a client-based data set. The development and implementation of a comprehensive information system require overcoming organizational barriers and project delays, fostering collaborative efforts among staff from diverse agencies, and employing considerable resources. In addition, the need to develop mechanisms for increasing the reliability of the data and ongoing training for the users is presented. Finally, three applications of the management information system's role in shaping policy are reviewed: developing services for special populations (communities of color, women, and pregnant substance abusers, and injection drug users), utilizing MIS data for evaluation purposes, and determining funding allocations.

Engineering aspects of design and integration of ECE diagnostic in ITER

DOE PAGES

Udintsev, V. S.; Taylor, G.; Pandya, H. K.B.; ...

2015-03-12

ITER ECE diagnostic [1] needs not only to meet measurement requirements, but also to withstand various loads, such as electromagnetic, mechanical, neutronic and thermal, and to be protected from stray ECH radiation at 170 GHz and other millimeter wave emission, like Collective Thomson scattering which is planned to operate at 60 GHz. Same or similar loads will be applied to other millimetre-wave diagnostics [2], located both in-vessel and in-port plugs. These loads must be taken into account throughout the design phases of the ECE and other microwave diagnostics to ensure their structural integrity and maintainability. The integration of microwave diagnosticsmore » with other ITER systems is another challenging activity which is currently ongoing through port integration and in-vessel integration work. Port Integration has to address the maintenance and the safety aspects of diagnostics, too. Engineering solutions which are being developed to support and to operate ITER ECE diagnostic, whilst complying with safety and maintenance requirements, are discussed in this paper.« less

In the strategies to prevent asthma exacerbations, allergic asthma needs specific treatment.

PubMed

Incorvaia, Cristoforo; Ridolo, Erminia

2015-04-01

No generally accepted definition of asthma exacerbation is thus far available, though in 2012 an expert committee endorsed by the National Institute of Health proposed such definition as "a worsening of asthma requiring the use of systemic corticosteroids to prevent a serious outcome". Graham and Eid reviewed the impact of asthma exacerbations, and noted that, analysing the outcomes with existing treatments, many patients with asthma remain symptomatic and experience exacerbations. This requires the introduction of new strategies to more effectively reduce the exacerbation risk, based on correct diagnosis, stopping smoking, correct inhaler technique, consistent adherence, weight management, and gaining control with the addition of medication". Indeed, as allergic asthma is the most common form, a specific approach by allergen immunotherapy should receive more attention. Actually, the efficacy of immunotherapy in allergic asthma, by the subcutaneous or the sublingual route, is supported by robust meta-analyses. The most important allergen source causing asthma is the house dust mite, but an increasing role for molds is apparent due to the ongoing climate change.

A review of recent literature - nurse case managers in diabetes care: equivalent or better outcomes compared to primary care providers.

PubMed

Watts, Sharon A; Lucatorto, Michelle

2014-07-01

Primary care has changed remarkably with chronic disease burden growth. Nurse case managers assist with this chronic disease by providing if not significantly better care, than equivalent care to that provided by usual primary care providers. Chronic disease management requires patient-centered skills and tools, such as registries, panel management, review of home data, communicating with patients outside of face-to-face care, and coordinating multiple services. Evidence reviewed in this article demonstrates that registered nurse care managers (RNCM) perform many actions required for diabetes chronic disease management including initiation and titration of medications with similar or improved physiologic and patient satisfaction outcomes over usual care providers. Selection and training of the nurse case managers is of utmost importance for implementation of a successful chronic disease management program. Evidence based guidelines, algorithms, protocols, and adequate ongoing education and mentoring are generally cited as necessary support tools for the nurse case managers.

DART -- Data acquisition for the next generation of Fermilab fixed target experiments

DOE Office of Scientific and Technical Information (OSTI.GOV)

Oleynik, G.; Anderson, J.; Appleton, L.

1994-02-01

DART is the name of the data acquisition effort for Fermilab experiments taking data in the '94--'95 time frame and beyond. Its charge is to provide a common system of hardware and software, which can be easily configured and extended to meet the wide range of data acquisition requirements of the experiments. Its strategy is to provide incrementally functional data acquisition systems to the experiments at frequent intervals to support the ongoing DA activities of the experiments. DART is a collaborative development effort between the experimenters and the Fermilab Computing Division. Experiments collaborating in DART cover a range of requirementsmore » from 400 Kbytes/sec event readout using a single DA processor, to 200 Mbytes/sec event readout involving 10 parallel readout streams, 10 VME event building planes and greater than 1,000 MIPs of event filter processing. The authors describe the requirements, architecture, and plans for the project and report on its current status.« less

Driving Extreme Efficiency to Market

NASA Astrophysics Data System (ADS)

Garbesi, Karina

2014-03-01

The rapid development of extremely energy efficient appliances and equipment is essential to curtail catastrophic climate disruption. This will require the on-going development of products that apply all best-practices and that take advantage of the synergies of hybridization and building integration. Beyond that, it requires the development of new disruptive technologies and concepts. To facilitate these goals, in 2011 the Lawrence Berkeley National Laboratory and the U.S. Department of Energy launched the Max Tech and Beyond Design Competition for Ultra-Low-Energy-Use Appliances and Equipment. Now in its third year, the competition supports faculty-lead student design teams at U.S. universities to develop and test new technology prototypes. This talk describes what the competition and the Max Tech Program are doing to drive such rapid technology progress and to facilitate the entry to the market of successful Max Tech prototypes. The talk also initiates a discussion of physicists' unique role in driving that technology progress faster and farther. Emerging Technologies, Building Technologies Office, U.S. Department of Energy.

Design of a pneumatically powered wearable exoskeleton with biomimetic support and actuation

NASA Astrophysics Data System (ADS)

Sergeyev, A.; Alaraje, N.; Seidel, C.; Carlson, Z.; Breda, B.

Powered exoskeletons are designed to assist and protect the wearer. Depending on the situation they may be used to protect soldiers and construction workers, aid the survival of people in dangerous environments, or assist patients in rehabilitation. Regardless of the application there are strict requirements for designing and producing exoskeleton suites. They must be durable but light weight and flexible, have reliable power control and modulation, capable of detecting unsafe and invalid motions, and may require significant weight lifting capabilities. In this article we present an on-going research on robotic exoskeleton replicating of human muscle functions. A single wearable knee-joint prototype described in this article combines the use of soft pneumatic muscle-like actuators and a control system based off the users own natural muscle signals. The Pneumatic Exoskeleton uses bioelectrical signals to detect movement intention from the pilot. This paper details the technical design aspects of a lower-limb robotic exoskeleton with possibility of further expansion to fully functioning robotic exoskeleton suit.

The Ebola epidemic and public health response.

PubMed

Moll, R; Reece, S; Cosford, P; Kessel, A

2016-03-01

An unprecedented global effort has been required to tackle the Ebola outbreak in West Africa. In this paper, we describe the contribution of Public Health England (PHE) in West Africa and the UK. Public Health England The epidemic has been a humanitarian crisis for the three worst affected countries. PHE contributions have included expertise in outbreak control and microbiology services in West Africa, and UK preparedness for an imported case. National and international systems require change to enhance the response to the next international public health crisis. Legacy planning following the epidemic will be crucial, supporting the recovery of the health and public health systems in West Africa and ensuring that the knowledge gained during this outbreak is put to best use. Ongoing PHE-associated research includes efforts to understand the pathogenicity of Ebola virus disease, improve diagnostic capability, explore therapeutic options and develop new vaccines. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

VLUIS, a land use data product for Victoria, Australia, covering 2006 to 2013

PubMed Central

Morse-McNabb, Elizabeth; Sheffield, Kathryn; Clark, Rob; Lewis, Hayden; Robson, Susan; Cherry, Don; Williams, Steve

2015-01-01

Land Use Information is a key dataset required to enable an understanding of the changing nature of our landscapes and the associated influences on natural resources and regional communities. The Victorian Land Use Information System (VLUIS) data product has been created within the State Government of Victoria to support land use assessments. The project began in 2007 using stakeholder engagement to establish product requirements such as format, classification, frequency and spatial resolution. Its genesis is significantly different to traditional methods, incorporating data from a range of jurisdictions to develop land use information designed for regular on-going creation and consistency. Covering the entire landmass of Victoria, the dataset separately describes land tenure, land use and land cover. These variables are co-registered to a common spatial base (cadastral parcels) across the state for the period 2006 to 2013; biennially for land tenure and land use, and annually for land cover. Data is produced as a spatial GIS feature class. PMID:26602150

VLUIS, a land use data product for Victoria, Australia, covering 2006 to 2013.

PubMed

Morse-McNabb, Elizabeth; Sheffield, Kathryn; Clark, Rob; Lewis, Hayden; Robson, Susan; Cherry, Don; Williams, Steve

2015-11-24

Land Use Information is a key dataset required to enable an understanding of the changing nature of our landscapes and the associated influences on natural resources and regional communities. The Victorian Land Use Information System (VLUIS) data product has been created within the State Government of Victoria to support land use assessments. The project began in 2007 using stakeholder engagement to establish product requirements such as format, classification, frequency and spatial resolution. Its genesis is significantly different to traditional methods, incorporating data from a range of jurisdictions to develop land use information designed for regular on-going creation and consistency. Covering the entire landmass of Victoria, the dataset separately describes land tenure, land use and land cover. These variables are co-registered to a common spatial base (cadastral parcels) across the state for the period 2006 to 2013; biennially for land tenure and land use, and annually for land cover. Data is produced as a spatial GIS feature class.

A conceptual prototype for the next-generation national elevation dataset

USGS Publications Warehouse

Stoker, Jason M.; Heidemann, Hans Karl; Evans, Gayla A.; Greenlee, Susan K.

2013-01-01

In 2012 the U.S. Geological Survey's (USGS) National Geospatial Program (NGP) funded a study to develop a conceptual prototype for a new National Elevation Dataset (NED) design with expanded capabilities to generate and deliver a suite of bare earth and above ground feature information over the United States. This report details the research on identifying operational requirements based on prior research, evaluation of what is needed for the USGS to meet these requirements, and development of a possible conceptual framework that could potentially deliver the kinds of information that are needed to support NGP's partners and constituents. This report provides an initial proof-of-concept demonstration using an existing dataset, and recommendations for the future, to inform NGP's ongoing and future elevation program planning and management decisions. The demonstration shows that this type of functional process can robustly create derivatives from lidar point cloud data; however, more research needs to be done to see how well it extends to multiple datasets.

Relationship between cancer-related traumatic stress and family milestone achievement in adolescent and young adult survivors of childhood cancer.

PubMed

Tillery, Rachel; Beal, Sarah J; Thompson, Aimee N; Pai, Ahna L H

2018-06-01

Late physical and emotional effects of cancer treatment pose a burden for adolescent and young adult survivors of childhood cancer, including family milestone achievement. This brief report examined links between ongoing cancer-related post-traumatic stress symptoms (CR-PTSS) and family milestone achievement. Survivors (n = 51; M age  = 24.73, SD = 8.20) completed CR-PTSS and family formation questionnaires. Descriptive statistics, univariate parameter-constraints, and correlation analyses examined relations among study variables. Ongoing intrusive thoughts and hyperarousal were negatively linked to family identity development and family achievement. Findings from the present study provide support that ongoing CR-PTSS may be a barrier to family formation. © 2018 Wiley Periodicals, Inc.

Epidemiology of Modern Battlefield Colorectal Trauma: A Review of 977 Coalition Casualties

DTIC Science & Technology

2012-01-01

records, the ongoing Joint Surgical Transcolonic Injury or Ostomy Multi-theater Assessment project quantifies epidemiologic trends in colon injury...Transcolonic Injury or Ostomy Multi-theater Assessment (J-STOMA) project is an ongoing initiative to examine outcomes from OIF/OEF specific to co... ostomy reversal; (4) quality of life in injured US Service members who require fecal diversion (temporary or permanent); and (5) incidence and outcomes

Rural Australian Women's Legal Help Seeking for Intimate Partner Violence: Women Intimate Partner Violence Victim Survivors' Perceptions of Criminal Justice Support Services

ERIC Educational Resources Information Center

Ragusa, Angela T.

2013-01-01

Intimate partner violence (IPV) is a widespread, ongoing, and complex global social problem, whose victims continue to be largely women. Women often prefer to rely on friends and family for IPV help, yet when informal support is unavailable they remain hesitant to contact formal services, particularly legal support for many reasons. This study…

ASRS Reports on Wake Vortex Encounters

NASA Technical Reports Server (NTRS)

Connell, Linda J.; Taube, Elisa Ann; Drew, Charles Robert; Barclay, Tommy Earl

2010-01-01

ASRS is conducting a structured callback research project of wake vortex incidents reported to the ASRS at all US airports, as well as wake encounters in the enroute environment. This study has three objectives: (1) Utilize the established ASRS supplemental data collection methodology and provide ongoing analysis of wake vortex encounter reports; (2) Document event dynamics and contributing factors underlying wake vortex encounter events; and (3) Support ongoing FAA efforts to address pre-emptive wake vortex risk reduction by utilizing ASRS reporting contributions.

Space Station Environmental Control and Life Support Systems: An Update on Waste Water Reclamation

NASA Technical Reports Server (NTRS)

Ferner, Kathleen M.

1994-01-01

Since the mid-1980's, work has been ongoing In the development of the various environmental control and life support systems (ECLSS) for the space station. Part of this effort has been focused on the development of a new subsystem to reclaim waste water that had not been previously required for shuttle missions. Because of the extended manned missions proposed, reclamation of waste water becomes imperative to avoid the weight penalties associated with resupplying a crew's entire water needs for consumption and daily hygiene. Hamilton Standard, under contract to Boeing Aerospace and Electronics, has been designing the water reclamation system for space station use. Since June of 1991, Hamilton Standard has developed a combined water processor capable of reclaiming potable quality water from waste hygiene water, used laundry water, processed urine, Shuttle fuel cell water, humidity condensate and other minor waste water sources. The system was assembled and then tested with over 27,700 pounds of 'real' waste water. During the 1700 hours of system operation required to process this waste water, potable quality water meeting NASA and Boeing specifications was produced. This paper gives a schematic overview of the system, describes the test conditions and test results and outlines the next steps for system development.

Clinician perceptions of personal safety and confidence to manage inpatient aggression in a forensic psychiatric setting.

PubMed

Martin, T; Daffern, M

2006-02-01

Inpatient mental health clinicians need to feel safe in the workplace. They also require confidence in their ability to work with aggressive patients, allowing the provision of therapeutic care while protecting themselves and other patients from psychological and physical harm. The authors initiated this study with the predetermined belief that a comprehensive and integrated organizational approach to inpatient aggression was required to support clinicians and that this approach increased confidence and staff perceptions of personal safety. To assess perceptions of personal safety and confidence, clinicians in a forensic psychiatric hospital were surveyed using an adapted version of the Confidence in Coping With Patient Aggression Instrument. In this study clinicians reported the hospital as safe. They reported confidence in their work with aggressive patients. The factors that most impacted on clinicians' confidence to manage aggression were colleagues' knowledge, experience and skill, management of aggression training, use of prevention and intervention strategies, teamwork and the staff profile. These results are considered with reference to an expanding literature on inpatient aggression. It is concluded that organizational resources, policies and frameworks support clinician perceptions of safety and confidence to manage inpatient aggression. However, how these are valued by clinicians and translated into practice at unit level needs ongoing attention.

Interprofessional learning modules at Dalhousie University.

PubMed

Johnston, G; Banks, S

2000-01-01

Interprofessional education has been advocated to improve teamwork in the health sector. This paper reports on the first two years of operational experience by a School of Health Services Administration (SHSA) with three-hour interprofessional learning modules (IPLMs). SHSA students participated along with students from nursing, medicine, social work, physiotherapy, occupational therapy, pharmacy, speech language pathology, audiology, dental hygiene, dentistry, leisure studies, health education and kinesiology. The five IPLMs required for SHSA students were: professional roles and values, integrity in scholarly activity, disability, interpersonal violence and HIV/AIDS. This article describes the development, delivery and evaluation of these modules from an SHSA perspective. The IPLMs' evaluation findings indicated that IPLMs are worthwhile, but have taken years and ongoing senior management support to operationalize; inclusion of health services administration is worthwhile but challenging; vigilance is needed to retain an IP rather than module content focus; and faculty and facilitator development, along with student preparation and debriefing, is required. Student feedback was favourable; faculty members have gained by their involvement; and field practitioner support has been sustained. Evaluation and reflection are critical to IPLM evolution. The norms, strengths and constraints of the university must be taken into account, and thus IPLMs must be adapted for each educational setting. Schools of health services administration must decide whether they wish to be involved in interprofessional learning.

One University Making a Difference in Graduate Education: Caring in the Online Learning Environment.

PubMed

Brown, Cynthia J; Wilson, Carol B

2016-12-01

As online education gains momentum, strategies to promote student engagement, develop social presence, and create a virtual community are essential for students' successful learning. A university with a philosophy grounded in caring developed two strategies for the graduate online education setting. These two strategies intentionally promote caring for self and others as a means to foster engagement, social presence, and a vibrant online community. One strategy was online Caring Groups, that is, small groups of four to five nursing students created each semester in one of the students' required courses in the online setting. The second strategy was the creation of two Caring Connections online sites, one for master of science in nursing students and one for doctorate in education nursing students. The sites were developed external to required courses to provide support for the online students throughout the graduate programs. Each site provides an ongoing space for students and faculty to post and discuss inspirational quotes, self-care tips, music, and photographs. The online Caring Groups and Caring Connections sites will be described, including how they were created, how they are used by students, how faculty support students, lessons learned, and how Caring Groups are integrated into the curriculum. © The Author(s) 2016.

Analysis of Security Protocols for Mobile Healthcare.

PubMed

Wazid, Mohammad; Zeadally, Sherali; Das, Ashok Kumar; Odelu, Vanga

2016-11-01

Mobile Healthcare (mHealth) continues to improve because of significant improvements and the decreasing costs of Information Communication Technologies (ICTs). mHealth is a medical and public health practice, which is supported by mobile devices (for example, smartphones) and, patient monitoring devices (for example, various types of wearable sensors, etc.). An mHealth system enables healthcare experts and professionals to have ubiquitous access to a patient's health data along with providing any ongoing medical treatment at any time, any place, and from any device. It also helps the patient requiring continuous medical monitoring to stay in touch with the appropriate medical staff and healthcare experts remotely. Thus, mHealth has become a major driving force in improving the health of citizens today. First, we discuss the security requirements, issues and threats to the mHealth system. We then present a taxonomy of recently proposed security protocols for mHealth system based on features supported and possible attacks, computation cost and communication cost. Our detailed taxonomy demonstrates the strength and weaknesses of recently proposed security protocols for the mHealth system. Finally, we identify some of the challenges in the area of security protocols for mHealth systems that still need to be addressed in the future to enable cost-effective, secure and robust mHealth systems.

Fire Weather Products for Public and Emergency Use: Extending Professional Resources to the Public

NASA Astrophysics Data System (ADS)

Rogers, M. A.; Schranz, S.; Kriederman, L.

2012-12-01

Large wildfires require significant resources to combat, including dedicated meteorological support to provide accurate and timely forecasts to assist incident commanders in making decisions for logistical and tactical firefighting operations. Smaller fires often require the same capabilities for understanding fire and the fire weather environment, but access to needed resources and tools is often limited due to technical, training, or education limitations. Providing fire weather information and training to incident commanders for smaller wildfires should prove to enhance firefighting capabilities and improve safety for both firefighters and for the public as well. One of the premier tools used to support fire weather forecasting for the largest wildfires is the FX-Net product, a thin-client version of the Advanced Weather Interactive Processing System used by NWS incident meteorologists (IMETs) deployed to large wildfires. We present results from an ongoing project to extend the sophisticated products available from FX-Net to more accessible and mobile software platforms, such as Google Earth. The project involves input from IMETs and fire commanders to identify the key parameters used in fighting wildfires, and involves a large training component for fire responders to utilize simplified products to improve understanding of fire weather in the context of firefighting operations.

Modafinil improves rapid shifts of attention.

PubMed

Marchant, Natalie L; Kamel, Faddy; Echlin, Kezia; Grice, John; Lewis, Mark; Rusted, Jennifer M

2009-01-01

The majority of studies investigating the cognitive effects of modafinil, a wake-promoting compound, demonstrate some improvements in attention. The potential of the drug to selectively benefit distinct components of attention has yet to be fully explored in healthy adults. The present study was conducted to investigate modafinil's effect on specific cognitive tasks that tax components of attention switching. One required the rapid switching of attention between stimuli, and another contained an embedded working memory component on top of the attentional shift requirements. Additionally, prospective memory was examined, which requires the interruption of an ongoing activity to retrieve and act upon a previously formed intention. Healthy non-smoking volunteers, matched on age, intelligence, and baseline cognitive ability, received either a capsule that contained 200 mg modafinil or placebo. Subjective measures of mood and physiological response were taken throughout the experimental session, and the tasks were completed between 2 and 3 h post-dosing. Two hundred milligrams modafinil improved accuracy without a reaction time trade-off, in both conditions of the attention-shifting task, but only when resources were most challenged. In contrast, the drug afforded no improvement in prospective remembering or in the ongoing task that was interrupted. Modafinil appears to promote rapid switching of attention in conditions that are most demanding, whilst it offers no benefits in a task that requires unpredictable and infrequent disengagement of attention from an ongoing task in order to act upon an alternative task.

Using computer decision support systems in NHS emergency and urgent care: ethnographic study using normalisation process theory

PubMed Central

2013-01-01

Background Information and communication technologies (ICTs) are often proposed as ‘technological fixes’ for problems facing healthcare. They promise to deliver services more quickly and cheaply. Yet research on the implementation of ICTs reveals a litany of delays, compromises and failures. Case studies have established that these technologies are difficult to embed in everyday healthcare. Methods We undertook an ethnographic comparative analysis of a single computer decision support system in three different settings to understand the implementation and everyday use of this technology which is designed to deal with calls to emergency and urgent care services. We examined the deployment of this technology in an established 999 ambulance call-handling service, a new single point of access for urgent care and an established general practice out-of-hours service. We used Normalization Process Theory as a framework to enable systematic cross-case analysis. Results Our data comprise nearly 500 hours of observation, interviews with 64 call-handlers, and stakeholders and documents about the technology and settings. The technology has been implemented and is used distinctively in each setting reflecting important differences between work and contexts. Using Normalisation Process Theory we show how the work (collective action) of implementing the system and maintaining its routine use was enabled by a range of actors who established coherence for the technology, secured buy-in (cognitive participation) and engaged in on-going appraisal and adjustment (reflexive monitoring). Conclusions Huge effort was expended and continues to be required to implement and keep this technology in use. This innovation must be understood both as a computer technology and as a set of practices related to that technology, kept in place by a network of actors in particular contexts. While technologies can be ‘made to work’ in different settings, successful implementation has been achieved, and will only be maintained, through the efforts of those involved in the specific settings and if the wider context continues to support the coherence, cognitive participation, and reflective monitoring processes that surround this collective action. Implementation is more than simply putting technologies in place – it requires new resources and considerable effort, perhaps on an on-going basis. PMID:23522021

Globalizing Lessons Learned from Regional-scale Observatories

NASA Astrophysics Data System (ADS)

Glenn, S. M.

2016-02-01

The Mid Atlantic Regional Association Coastal Ocean Observing System (MARACOOS) has accumulated a decade of experience designing, building and operating a Regional Coastal Ocean Observing System for the U.S. Integrated Ocean Observing System (IOOS). MARACOOS serves societal goals and supports scientific discovery at the scale of a Large Marine Ecosystem (LME). Societal themes include maritime safety, ecosystem decision support, coastal inundation, water quality and offshore energy. Scientific results that feed back on societal goals with better products include improved understanding of seasonal transport pathways and their impact on phytoplankton blooms and hypoxia, seasonal evolution of the subsurface Mid Atlantic Cold Pool and its impact on fisheries, biogeochemical transformations in coastal plumes, coastal ocean evolution and impact on hurricane intensities, and storm sediment transport pathways. As the global ocean observing requirements grow to support additional societal needs for information on fisheries and aquaculture, ocean acidification and deoxygenation, water quality and offshore development, global observing will necessarily evolve to include more coastal observations and forecast models at the scale of the world's many LMEs. Here we describe our efforts to share lessons learned between the observatory operators at the regional-scale of the LMEs. Current collaborators are spread across Europe, and also include Korea, Indonesia, Australia, Brazil and South Africa. Specific examples include the development of a world standard QA/QC approach for HF Radar data that will foster the sharing of data between countries, basin-scale underwater glider missions between internationally-distributed glider ports to developed a shared understanding of operations and an ongoing evaluation of the global ocean models in which the regional models for the LME will be nested, and joint training programs to develop the distributed teams of scientists and technicians required to support the global network. Globalization includes the development of international networks to coordinate activities, such as the Global HF Radar network supported by GEO, the global Everyone's Glider Organization supported by WMO and IOC, and the need for professional training supported by MTS.

Partnership, inclusion and innovation in occupational therapy: Essential or optional ingredients to flourish in a changing environment?

PubMed

Gilbert Hunt, Susan

2017-12-01

Historically occupational therapy has evidenced a tenacity to adjust and adapt to societal changes. Currently in Australia we are in the midst of significant change in health, disability and aged care service delivery alongside increasing numbers of new graduates seeking employment. Both of these changes create challenges and opportunities for the profession. How the profession adjusts to new service delivery models and supports new graduates in this changing work environment will influence our future. Using examples from practice the paper explores ways in which partnership, inclusion and innovation can be effective in a changing environment. Doing effective partnership takes time, energy and a shared commitment of all involved and often requires negotiations and compromise. Inclusion can be tricky and requires vigilance and ongoing reflection on actions to determine if the outcomes are what was intended. Innovation can play two roles; it can be used to conserve current practice in new ways or it can offer agency to disrupt and redefine practice. The way in which the profession chooses to enact partnerships and inclusion will play a vital role in shaping the future. Similarly the space and support made for conservative or disruptive innovation will determine how we choose to define ourselves going forward. Moreover, these choices and actions will govern how effective we are in navigating the changing environment and supporting new graduates transitioning into the profession. © 2017 Occupational Therapy Australia.

Compilation of new and previously published geochemical and modal data for Mesoproterozoic igneous rocks of the St. Francois Mountains, southeast Missouri

USGS Publications Warehouse

du Bray, Edward A.; Day, Warren C.; Meighan, Corey J.

2018-04-16

The purpose of this report is to present recently acquired as well as previously published geochemical and modal petrographic data for igneous rocks in the St. Francois Mountains, southeast Missouri, as part of an ongoing effort to understand the regional geology and ore deposits of the Mesoproterozoic basement rocks of southeast Missouri, USA. The report includes geochemical data that is (1) newly acquired by the U.S. Geological Survey and (2) compiled from numerous sources published during the last fifty-five years. These data are required for ongoing petrogenetic investigations of these rocks. Voluminous Mesoproterozoic igneous rocks in the St. Francois Mountains of southeast Missouri constitute the basement buried beneath Paleozoic sedimentary rock that is over 600 meters thick in places. The Mesoproterozoic rocks of southeast Missouri represent a significant component of approximately 1.4 billion-year-old (Ga) igneous rocks that crop out extensively in North America along the southeast margin of Laurentia and subsequent researchers suggested that iron oxide-copper deposits in the St. Francois Mountains are genetically associated with ca. 1.4 Ga magmatism in this region. The geochemical and modal data sets described herein were compiled to support investigations concerning the tectonic setting and petrologic processes responsible for the associated magmatism.

Improving vocational rehabilitation services for injured workers in Washington State.

PubMed

Sears, Jeanne M; Wickizer, Thomas M; Schulman, Beryl A

2014-06-01

Workers who incur permanent impairments or have ongoing medical restrictions due to injuries or illnesses sustained at work may require support from vocational rehabilitation programs in order to return to work. Vocational rehabilitation programs implemented within workers' compensation settings are costly, and effective service delivery has proven challenging. The Vocational Improvement Project, a 5.5-year pilot program beginning in 2008, introduced major changes to the Washington State workers' compensation-based vocational rehabilitation program. In the evaluation of this pilot program, set within a large complex system characterized by competing stakeholder interests, we assessed effects on system efficiency and employment outcomes for injured workers. While descriptive in nature, this evaluation provided evidence that several of the intended outcomes were attained, including: (1) fewer repeat referrals, (2) fewer delays, (3) increased choice for workers, and (4) establishment of statewide partnerships to improve worker outcomes. There remains substantial room for further improvement. Retraining plan completion rates remain under 60% and only half of workers earned any wages within two years of completing their retraining plan. Ongoing communication with stakeholders was critical to the successful conduct and policy impact of this evaluation, which culminated in a 3-year extension of the pilot program through June 2016. Copyright © 2013 Elsevier Ltd. All rights reserved.

The Politics of Information: Building a Relational Database To Support Decision-Making at a Public University.

ERIC Educational Resources Information Center

Friedman, Debra; Hoffman, Phillip

2001-01-01

Describes creation of a relational database at the University of Washington supporting ongoing academic planning at several levels and affecting the culture of decision making. Addresses getting started; sharing the database; questions, worries, and issues; improving access to high-demand courses; the advising function; management of instructional…

Effectiveness of the Civil Aviation Security Program.

DTIC Science & Technology

1980-05-22

SECURITY. - CONTINUED TRAINING OF LAW ENFORCEMENT OFFICERS SUPPORTING AIRPORT SECURITY ACTIVITIES. - SECURITY PROGRAMS IMPLEMENTED BY AIR FREIGHT...cooperation by all concerned. (See Exhibit 14) Airport Security - Ongoing activities which contributed significantly to airport security included full...implementation of the revised Federal Aviation Regulations (FAR) Part 107 governing airport security , training of law enforcement officers supporting

A Design of Electronic Performance Support Systems.

ERIC Educational Resources Information Center

Sheu, Feng-Ru

The project described in this paper, representing the initial phases of a one-year on-going project, was organized to build a supportive environment for Instructional Systems Technology (IST) doctoral students at Indiana University-Bloomington to help them prepare for the Qualifying exams. An overview is provided of steps taken to create an…

77 FR 3781 - Pediatric Medical Devices; Public Workshop; Reopening of Comment Period

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-25

... discussion of how to determine when it is appropriate to use, and how to use, existing scientific research... use of scientific research data to support pediatric medical device efficacy claims. This is part of an on-going effort to address the ways scientific research data can be used to support pediatric...

A Sustainable Model for Training Teachers to Use Pivotal Response Training

ERIC Educational Resources Information Center

Suhrheinrich, Jessica

2015-01-01

The increase in the rate of autism diagnoses has created a growing demand for teachers who are trained to use effective interventions. The train-the-trainer model, which involves training supervisors to train others, may be ideal for providing cost-effective training and ongoing support to teachers. Although research supports interventions, such…

Connections: Facilitating Social Supports for Students with Deaf-Blindness in General Education Classrooms.

ERIC Educational Resources Information Center

Goetz, Lori; O'Farrell, Nora

1999-01-01

This article describes a three-component package to facilitate social supports for students who are deaf-blind in general education classes. The components are: ongoing provision of information, provision of interactive, multiple communication media, and facilitation of social interactions. Case studies of four students with deaf-blindness…

Video-Stimulated Recall as a Catalyst for Teacher Professional Learning

ERIC Educational Resources Information Center

Geiger, Vince; Muir, Tracey; Lamb, Janeen

2016-01-01

The purpose of this article is to examine the potential of video-catalysed reflective practice for supporting ongoing teacher professional learning in numeracy. We explore this potential through a synthesis of two case studies that investigated different approaches to supporting teacher reflection on practice through the use of video-stimulated…

The Effect of Oral Feedback on Perceived Classroom Community in Undergraduate Students

ERIC Educational Resources Information Center

Boyles, Jennifer L.

2017-01-01

The ongoing trend in research regarding feedback has been to explore quantitative assessment. Garnering support more recently is qualitative narrative feedback in support of formative assessment. This type of feedback offers insight into expectations as well as offer additional knowledge gained. It enables students to improve their performance…

It Takes Research to Build a Community: Ongoing Challenges for Scholars in Digitally-Supported Communicative Language Teaching

ERIC Educational Resources Information Center

Dooly, Melinda

2015-01-01

This article provides an argument for closer multilateral alliances between the emergent and loosely-bound international community of educational researchers who are working in areas related to Digitally Supported Communicative Language Teaching and learning (herein DSCLT). By taking advantage of the communications revolution that is currently…

75 FR 39950 - Proposed Collection; Comment Request; Cancer Trials Support Unit (CTSU) Public Use Forms and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-13

... Request; Cancer Trials Support Unit (CTSU) Public Use Forms and Customer Satisfaction Surveys (NCI... of customer satisfaction for clinical site staff using the CTSU Help Desk and the CTSU web site. An ongoing user satisfaction survey is in place for the Oncology Patient Enrollment Network (OPEN). User...

Not a One-Way Street: Bidirectional Relations between Procedural and Conceptual Knowledge of Mathematics

ERIC Educational Resources Information Center

Rittle-Johnson, Bethany; Schneider, Michael; Star, Jon R.

2015-01-01

There is a long-standing and ongoing debate about the relations between conceptual and procedural knowledge (i.e., knowledge of concepts and procedures). Although there is broad consensus that conceptual knowledge supports procedural knowledge, there is controversy over whether procedural knowledge supports conceptual knowledge and how instruction…

Ongoing child welfare services: Understanding the relationship of worker and organizational characteristics to service provision.

PubMed

Lwin, Kristen; Fluke, John; Trocmé, Nico; Fallon, Barbara; Mishna, Faye

2018-06-01

Ongoing child welfare services are put in place after completion of the initial maltreatment investigation when there is a perceived need to mitigate the risk of future harm. The knowledge of how clinical, worker, and organizational characteristics interact with this decision to provide ongoing child welfare services is not well integrated in the research literature. Using secondary data from the Canadian Incidence Study of Reported Child Abuse and Neglect-2008, this study's primary objective is to understand the relationship of clinical, worker, and organizational characteristics to the decision to transfer a case to ongoing child welfare services and their relative contribution to the transfer decision in Canada. Findings indicate that several clinical level variables are associated with families receiving ongoing services. Additionally, organizational factors, such as type of services offered by the organization and the number of employee support programs available to workers, significantly predicted the decision to transfer a case to ongoing services. While no worker factors, such as education, amount of training, experience, or caseload, were associated with ongoing service receipt, the intraclass correlation coefficient of the final three-level parsimonious model indicated substantial clustering at the worker level. Results indicate that Canadian child welfare workers make decisions differently based on factors not available in the current study and that what would be deemed as important worker characteristics do not necessarily predict this outcome. Findings and implications for future research are discussed. Copyright © 2018 Elsevier Ltd. All rights reserved.

11 CFR 116.8 - Creditor forgiveness of debts owed by ongoing committees; Commission review.

Code of Federal Regulations, 2010 CFR

2010-01-01

... committees; Commission review. (a) General requirements. A creditor may forgive the outstanding balance of a... requirements of 11 CFR 116.3 or 116.5, as appropriate, regarding extensions of credit by commercial vendors and...

ARL Support of NRL Rocket Experiments to Investigate Ionospheric Phenomena

DTIC Science & Technology

2010-08-31

reallocate the funds to support NRL’s ongoing efforts to develop an ionospheric tomography network in South America to support the C/NOFS satellite...of NRL Rocket Experiments to Investigate Ionospheric Phenomena 5a. CONTRACT NUMBER N00173-09-1-G036 5b. GRANT NUMBER N00173-09-1-G036 5c...1-G036 ARL Support of NRL Rocket Experiments to Investigate Ionospheric Phenomena BY DR. TREVOR W. GARNER APPLIED RESEARCH LABORATORIES THE

Training peers to provide ongoing diabetes self-management support (DSMS): Results from a pilot study

PubMed Central

Tang, Tricia S.; Funnell, Martha M.; Gillard, Marylou; Nwankwo, Robin; Heisler, Michele

2013-01-01

Objective This study determined the feasibility of training adults with diabetes to lead diabetes self-management support (DSMS) interventions, examined whether participants can achieve the criteria required for successful graduation, and assessed perceived efficacy of and satisfaction with the peer leader training (PLT) program. Methods We recruited nine African-American adults with diabetes for a 46-hour PLT pilot program conducted over 12 weeks. The program utilized multiple instructional methods, reviewed key diabetes education content areas, and provided communication, facilitation, and behavior change skills training. Participants were given three attempts to achieve the pre-established competency criteria for diabetes knowledge, empowerment-based facilitation, active listening, and self-efficacy. Results On the first attempt 75%, 75%, 63%, and 75% passed diabetes knowledge, empowerment-based facilitation, active listening, and self-efficacy, respectively. Those participants who did not pass on first attempt passed on the second attempt. Participants were highly satisfied with the program length, balance between content and skills development, and preparation for leading support activities. Conclusion Findings suggest that it is feasible to train and graduate peer leaders with the necessary knowledge and skills to facilitate DSMS interventions. Practical Implications With proper training, peer support may be a viable model for translating and sustaining DSMS interventions into community-based settings. PMID:21292425

Evolving Prehospital, Emergency Department, and “Inpatient” Management Models for Geriatric Emergencies

PubMed Central

Carpenter, Christopher R.; Platts-Mills, Timothy F.

2013-01-01

Alternative management methods are essential to ensure high quality and efficient emergency care for the growing number of geriatric adults worldwide. Protocols for case-finding and rapid diagnosis to support early condition-specific treatment for older adults with acute severe illness and injury are needed. Improved emergency department care for older adults will require providers to look beyond the diagnosis to address the influence of other factors on the patient's health: isolation and depression; finances and transportation; and chronic medical conditions and polypharmacy. This review article describes recent and ongoing efforts to enhance the quality of emergency care for older adults using alternative management approaches spanning the spectrum from prehospital care, through the emergency department, and into evolving inpatient or outpatient processes of care. PMID:23177599

Survey of university programs in remote sensing funded under grants from the NASA University-Space Applications program

NASA Technical Reports Server (NTRS)

Madigan, J. A.; Earhart, R. W.

1978-01-01

NASA's Office of Space and Terrestrial Applications (OSTA) is currently assessing approaches to transferring NASA technology to both the public and private sectors. As part of this assessment, NASA is evaluating the effectiveness of an ongoing program in remote sensing technology transfer conducted by 20 university contractors/grantees, each supported totally or partially by NASA funds. The University-Space Applications program has as its objective the demonstration of practical benefits from the use of remote sensing technology to a broad spectrum of new users, principally in state and local governments. To evaluate the University-Space Applications program, NASA has a near-term requirement for data on each university effort including total funding, funding sources, length of program, program description, and effectiveness measures.

Learning from Non-Linear Ecosystem Dynamics Is Vital for Achieving Land Degradation Neutrality

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sietz, Diana; Fleskens, Luuk; Stringer, Lindsay C.

Land Degradation Neutrality is one of the Sustainable Development Goal targets, requiring on-going degradation to be balanced by restoration and sustainable land management. However, restoration and efforts to prevent degradation have often failed to deliver expected benefits,despite enormous investments. Better acknowledging the close relationships between climate, land management and non-linear ecosystem dynamics can help restoration activities to meet their intended goals, while supporting climate change adaptation and mitigation. This paper is the first to link ecological theory of non-linear ecosystem dynamics to Land Degradation Neutrality offering essential insights into appropriate timings, climate-induced windows of opportunities and risks and the financialmore » viability of investments. These novel insights are pre-requisites for meaningful o and monitoring of progress towards Land Degradation Neutrality« less

Learning from Non-Linear Ecosystem Dynamics Is Vital for Achieving Land Degradation Neutrality

DOE PAGES

Sietz, Diana; Fleskens, Luuk; Stringer, Lindsay C.

2017-02-27

Land Degradation Neutrality is one of the Sustainable Development Goal targets, requiring on-going degradation to be balanced by restoration and sustainable land management. However, restoration and efforts to prevent degradation have often failed to deliver expected benefits,despite enormous investments. Better acknowledging the close relationships between climate, land management and non-linear ecosystem dynamics can help restoration activities to meet their intended goals, while supporting climate change adaptation and mitigation. This paper is the first to link ecological theory of non-linear ecosystem dynamics to Land Degradation Neutrality offering essential insights into appropriate timings, climate-induced windows of opportunities and risks and the financialmore » viability of investments. These novel insights are pre-requisites for meaningful o and monitoring of progress towards Land Degradation Neutrality« less

Triso coating development progress for uranium nitride kernels

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jolly, Brian C.; Lindemer, Terrence; Terrani, Kurt A.

2015-08-01

In support of fully ceramic matrix (FCM) fuel development [1-2], coating development work is ongoing at the Oak Ridge National Laboratory (ORNL) to produce tri-structural isotropic (TRISO) coated fuel particles with UN kernels [3]. The nitride kernels are used to increase fissile density in these SiC-matrix fuel pellets with details described elsewhere [4]. The advanced gas reactor (AGR) program at ORNL used fluidized bed chemical vapor deposition (FBCVD) techniques for TRISO coating of UCO (two phase mixture of UO2 and UCx) kernels [5]. Similar techniques were employed for coating of the UN kernels, however significant changes in processing conditions weremore » required to maintain acceptable coating properties due to physical property and dimensional differences between the UCO and UN kernels (Table 1).« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pope, Jason E.

For more than 50 years, the United States (U.S.) Department of Energy’s (DOE’s) Pacific Northwest National Laboratory (PNNL) has advanced the frontiers of science and technology through courageous discovery and innovation. Our multidisciplinary team of more than 4,400 scientists, engineers, and support professionals is tackling global sustainability challenges in our science, energy, environmental, and security missions. For example, our research on how human and natural systems interact is critical to informing sustainable solutions to the nation’s energy and environmental challenges. PNNL is equally committed to sustainability right here at home, and we are making excellent progress toward the goals describedmore » in this plan. We are working on ongoing challenges, such as reducing the energy required to meet our research mission and promoting conservation among our employees.« less

HIPAA is larger and more complex than Y2K.

PubMed

Tempesco, J W

2000-07-01

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a larger and more complex problem than Y2K ever was. According to the author, the costs associated with a project of such unending scope and in support of intrusion into both information and operational systems of every health care transaction will be incalculable. Some estimate that the administrative simplification policies implemented through HIPAA will save billions of dollars annually, but it remains to be seen whether the savings will outweigh implementation and ongoing expenses associated with systemwide application of the regulations. This article addresses the rules established for electronic data interchange, data set standards for diagnostic and procedure codes, unique identifiers, coordination of benefits, privacy of individual health care information, electronic signatures, and security requirements.

Tool Use Within NASA Software Quality Assurance

NASA Technical Reports Server (NTRS)

Shigeta, Denise; Port, Dan; Nikora, Allen P.; Wilf, Joel

2013-01-01

As space mission software systems become larger and more complex, it is increasingly important for the software assurance effort to have the ability to effectively assess both the artifacts produced during software system development and the development process itself. Conceptually, assurance is a straightforward idea - it is the result of activities carried out by an organization independent of the software developers to better inform project management of potential technical and programmatic risks, and thus increase management's confidence in the decisions they ultimately make. In practice, effective assurance for large, complex systems often entails assessing large, complex software artifacts (e.g., requirements specifications, architectural descriptions) as well as substantial amounts of unstructured information (e.g., anomaly reports resulting from testing activities during development). In such an environment, assurance engineers can benefit greatly from appropriate tool support. In order to do so, an assurance organization will need accurate and timely information on the tool support available for various types of assurance activities. In this paper, we investigate the current use of tool support for assurance organizations within NASA, and describe on-going work at JPL for providing assurance organizations with the information about tools they need to use them effectively.

Power mobility with collision avoidance for older adults: user, caregiver, and prescriber perspectives.

PubMed

Wang, Rosalie H; Korotchenko, Alexandra; Hurd Clarke, Laura; Mortenson, W Ben; Mihailidis, Alex

2013-01-01

Collision avoidance technology has the capacity to facilitate safer mobility among older power mobility users with physical, sensory, and cognitive impairments, thus enabling independence for more users. Little is known about consumers' perceptions of collision avoidance. This article draws on interviews (29 users, 5 caregivers, and 10 prescribers) to examine views on design and utilization of this technology. Data analysis identified three themes: "useful situations or contexts," "technology design issues and real-life application," and "appropriateness of collision avoidance technology for a variety of users." Findings support ongoing development of collision avoidance for older adult users. The majority of participants supported the technology and felt that it might benefit current users and users with visual impairments, but might be unsuitable for people with significant cognitive impairments. Some participants voiced concerns regarding the risk for injury with power mobility use and some identified situations where collision avoidance might be beneficial (driving backward, avoiding dynamic obstacles, negotiating outdoor barriers, and learning power mobility use). Design issues include the need for context awareness, reliability, and user interface specifications. User desire to maintain driving autonomy supports development of collaboratively controlled systems. This research lays the groundwork for future development by illustrating consumer requirements for this technology.

Collaborating with Youth to Inform and Develop Tools for Psychotropic Decision Making

PubMed Central

Murphy, Andrea; Gardner, David; Kutcher, Stan; Davidson, Simon; Manion, Ian

2010-01-01

Introduction: Youth oriented and informed resources designed to support psychopharmacotherapeutic decision-making are essentially unavailable. This article outlines the approach taken to design such resources, the product that resulted from the approach taken, and the lessons learned from the process. Methods: A project team with psychopharmacology expertise was assembled. The project team reviewed best practices regarding medication educational materials and related tools to support decisions. Collaboration with key stakeholders who were thought of as primary end-users and target groups occurred. A graphic designer and a plain language consultant were also retained. Results: Through an iterative and collaborative process over approximately 6 months, Med Ed and Med Ed Passport were developed. Literature and input from key stakeholders, in particular youth, was instrumental to the development of the tools and materials within Med Ed. A training program utilizing a train-the-trainer model was developed to facilitate the implementation of Med Ed in Ontario, which is currently ongoing. Conclusion: An evidence-informed process that includes youth and key stakeholder engagement is required for developing tools to support in psychopharmacotherapeutic decision-making. The development process fostered an environment of reciprocity between the project team and key stakeholders. PMID:21037916

Leaning in and holding on: team support with unexpected death.

PubMed

Kobler, Kathie

2014-01-01

Integral to the care of medically fragile infants and children is the sobering reality that not all will survive. Supporting children and families through the dying process requires knowledge, skill, compassion, and a willingness to be present to the suffering of others. As healthcare professionals journey with a dying child, they experience an ongoing dual nature of their own grief, shifting between focusing on the loss at hand or avoiding the loss and refocusing their attention elsewhere. This internal conflict may be potentiated with the sudden, unexpected death of a patient, which affords little time for caregivers to process their own experience of the loss. When an unanticipated death occurs, a palpable grief ripples through the entire unit, impacting caregivers, the bereaved parents, and other patients and families. Such an event holds the potential for either team disorganization or growth. This article presents a case study of one unit's response to the unexpected death of a long-term patient, which caused caregivers to lean in to support each other. Using a case study approach, the author identifies strategies to best guide teams when death arrives without warning, and provides ideas for cocreating ritual to honor relationship in the midst of tragedy.

Qualitative study: the experience and impact of living with Behcet's syndrome.

PubMed

Tai, Vicky; Lindsay, Karen; Sims, Joanne L; McQueen, Fiona M

2017-09-22

Behcet's syndrome is a rare chronic multisystemic vasculitis of unknown aetiology, is unpredictable and can cause life-threatening complications. This qualitative study aims to explore the experiences of patients living with Behcet's syndrome in New Zealand. Eight English-speaking patients participated in in-depth semi-structured interviews about their experiences of living with Behcet's syndrome. Interviews were recorded and transcribed. Data were analysed using a general inductive thematic approach. Five themes related to the experience of Behcet's syndrome emerged from the interviews: diagnosis (diagnostic challenge and closure), impact of disease (pain, fatigue, reduced vision, fear and uncertainty), loneliness and isolation (lack of support and information, invisible illness), acquiring resilience (coping, gaining sense of control, support group) and ongoing interactions with health system (specialist care, primary care, need for multidisciplinary care, doctor-patient relationship). Behcet's syndrome patients experience difficulties in obtaining a timely and correct diagnosis and contend numerous physical and emotional challenges, often experiencing loneliness and isolation. Establishing trusting doctor-patient relationships, allowing timely access to specialist care and recruiting psychosocial supports will help patients better cope with their illness. Diagnosis and management of Behcet's syndrome requires close collaboration and communication among specialists and general practitioners and improved education on Behcet's syndrome.

MDMA-assisted therapy: A new treatment model for social anxiety in autistic adults.

PubMed

Danforth, Alicia L; Struble, Christopher M; Yazar-Klosinski, Berra; Grob, Charles S

2016-01-04

The first study of 3,4-methylenedioxymethamphetamine (MDMA)-assisted therapy for the treatment of social anxiety in autistic adults commenced in the spring of 2014. The search for psychotherapeutic options for autistic individuals is imperative considering the lack of effective conventional treatments for mental health diagnoses that are common in this population. Serious Adverse Events (SAEs) involving the administration of MDMA in clinical trials have been rare and non-life threatening. To date, MDMA has been administered to over 1133 individuals for research purposes without the occurrence of unexpected drug-related SAEs that require expedited reporting per FDA regulations. Now that safety parameters for limited use of MDMA in clinical settings have been established, a case can be made to further develop MDMA-assisted therapeutic interventions that could support autistic adults in increasing social adaptability among the typically developing population. As in the case with classic hallucinogens and other psychedelic drugs, MDMA catalyzes shifts toward openness and introspection that do not require ongoing administration to achieve lasting benefits. This infrequent dosing mitigates adverse event frequency and improves the risk/benefit ratio of MDMA, which may provide a significant advantage over medications that require daily dosing. Consequently, clinicians could employ new treatment models for social anxiety or similar types of distress administering MDMA on one to several occasions within the context of a supportive and integrative psychotherapy protocol. Copyright © 2015 Elsevier Inc. All rights reserved.

Paediatric emergency and acute care in resource poor settings.

PubMed

Duke, Trevor; Cheema, Baljit

2016-02-01

Acute care of seriously ill children is a global public health issue, and there is much scope for improving quality of care in hospitals at all levels in many developing countries. We describe the current state of paediatric emergency and acute care in the least developed regions of low and middle income countries and identify gaps and requirements for improving quality. Approaches are needed which span the continuum of care: from triage and emergency treatment, the diagnostic process, identification of co-morbidities, treatment, monitoring and supportive care, discharge planning and follow-up. Improvements require support and training for health workers and quality processes. Effective training is that which is ongoing, combining good technical training in under-graduate courses and continuing professional development. Quality processes combine evidence-based guidelines, essential medicines, appropriate technology, appropriate financing of services, standards and assessment tools and training resources. While initial emergency treatment is based on common clinical syndromes, early differentiation is required for specific treatment, and this can usually be carried out clinically without expensive tests. While global strategies are important, it is what happens locally that makes a difference and is too often neglected. In rural areas in the poorest countries in the world, public doctors and nurses who provide emergency and acute care for children are revered by their communities and demonstrate daily that much can be carried out with little. © 2016 The Authors. Journal of Paediatrics and Child Health © 2016 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Ernest Orlando Lawrence Berkeley National Laboratory institutional plan, FY 1996--2001

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1995-11-01

The FY 1996--2001 Institutional Plan provides an overview of the Ernest Orlando Lawrence Berkeley National Laboratory mission, strategic plan, core business areas, critical success factors, and the resource requirements to fulfill its mission in support of national needs in fundamental science and technology, energy resources, and environmental quality. The Laboratory Strategic Plan section identifies long-range conditions that will influence the Laboratory, as well as potential research trends and management implications. The Core Business Areas section identifies those initiatives that are potential new research programs representing major long-term opportunities for the Laboratory, and the resources required for their implementation. It alsomore » summarizes current programs and potential changes in research program activity, science and technology partnerships, and university and science education. The Critical Success Factors section reviews human resources; work force diversity; environment, safety, and health programs; management practices; site and facility needs; and communications and trust. The Resource Projections are estimates of required budgetary authority for the Laboratory`s ongoing research programs. The Institutional Plan is a management report for integration with the Department of Energy`s strategic planning activities, developed through an annual planning process. The plan identifies technical and administrative directions in the context of the national energy policy and research needs and the Department of Energy`s program planning initiatives. Preparation of the plan is coordinated by the Office of Planning and Communications from information contributed by the Laboratory`s scientific and support divisions.« less

Assessing land-use impacts on biodiversity using an expert systems tool

USGS Publications Warehouse

Crist, P.J.; Kohley, T.W.; Oakleaf, J.

2000-01-01

Habitat alteration, in the form of land-use development, is a leading cause of biodiversity loss in the U.S. and elsewhere. Although statutes in the U.S. may require consideration of biodiversity in local land-use planning and regulation, local governments lack the data, resources, and expertise to routinely consider biotic impacts that result from permitted land uses. We hypothesized that decision support systems could aid solution of this problem. We developed a pilot biodiversity expert systems tool (BEST) to test that hypothesis and learn what additional scientific and technological advancements are required for broad implementation of such a system. BEST uses data from the U.S. Geological Survey's Gap Analysis Program (GAP) and other data in a desktop GIS environment. The system provides predictions of conflict between proposed land uses and biotic elements and is intended for use at the start of the development review process. Key challenges were the development of categorization systems that relate named land-use types to ecological impacts, and relate sensitivities of biota to ecological impact levels. Although the advent of GAP and sophisticated desktop GIS make such a system feasible for broad implementation, considerable ongoing research is required to make the results of such a system scientifically sound, informative, and reliable for the regulatory process. We define a role for local government involvement in biodiversity impact assessment, the need for a biodiversity decision support system, the development of a prototype system, and scientific needs for broad implementation of a robust and reliable system.

Space transfer vehicle concepts and requirements. Volume 4: Summary of special studies

NASA Technical Reports Server (NTRS)

1993-01-01

Our final report for Phase 1 addressed the future space transportation needs and requirements based on the current assets, at the time, and their evolution through technology/advanced development using a path and schedule that supported the world leadership role of the United States in a responsible and realistic financial forecast. Always, and foremost, the recommendations placed high values on the safety and success of missions both manned and unmanned through a total quality management philosophy at Martin Marietta. The second phase of the STV contract involved the use of Technical Directives (TD) to provide short-term support for specialized tasks as required by the COTR. Three of these tasks were performed in parallel with Phase 1. These tasks were the Liquid Acquisition Experiment (LACE), Liquid Reorientation Experiment (LIRE), and Expert System for Design, Operation, and Technology Studies (ESDOTS). The results of these TD's were reported in conjunction with the Phase 1 Final Report. Cost analysis of existing launch systems has demonstrated a need for a new upper stage that will increase America's competitiveness in the global launch services market. To provide a growth path of future exploration class STV's, near-term low-cost upper stages featuring modularity, portability, scalability, and evolvability must be developed. These recommendations define a program that: leverages ongoing activities to establish a new development environment, develop technologies that benefit the entire life cycle of a system, and result in a scalable hardware platform that provides a growth path to future upper stages.

National Land Imaging Requirements (NLIR) Pilot Project summary report: summary of moderate resolution imaging user requirements

USGS Publications Warehouse

Vadnais, Carolyn; Stensaas, Gregory

2014-01-01

Under the National Land Imaging Requirements (NLIR) Project, the U.S. Geological Survey (USGS) is developing a functional capability to obtain, characterize, manage, maintain and prioritize all Earth observing (EO) land remote sensing user requirements. The goal is a better understanding of community needs that can be supported with land remote sensing resources, and a means to match needs with appropriate solutions in an effective and efficient way. The NLIR Project is composed of two components. The first component is focused on the development of the Earth Observation Requirements Evaluation System (EORES) to capture, store and analyze user requirements, whereas, the second component is the mechanism and processes to elicit and document the user requirements that will populate the EORES. To develop the second component, the requirements elicitation methodology was exercised and refined through a pilot project conducted from June to September 2013. The pilot project focused specifically on applications and user requirements for moderate resolution imagery (5–120 meter resolution) as the test case for requirements development. The purpose of this summary report is to provide a high-level overview of the requirements elicitation process that was exercised through the pilot project and an early analysis of the moderate resolution imaging user requirements acquired to date to support ongoing USGS sustainable land imaging study needs. The pilot project engaged a limited set of Federal Government users from the operational and research communities and therefore the information captured represents only a subset of all land imaging user requirements. However, based on a comparison of results, trends, and analysis, the pilot captured a strong baseline of typical applications areas and user needs for moderate resolution imagery. Because these results are preliminary and represent only a sample of users and application areas, the information from this report should only be used to indicate general user needs for the applications covered. Users of the information are cautioned that use of specific numeric results may be inappropriate without additional research. Any information used or cited from this report should specifically be cited as preliminary findings.

The SCIDIP-ES project - towards an international collaboration strategy for long term preservation of earth science data

NASA Astrophysics Data System (ADS)

Riddick, Andrew; Glaves, Helen; Marelli, Fulvio; Albani, Mirko; Tona, Calogera; Marketakis, Yannis; Tzitzikas, Yannis; Guarino, Raffaele; Giaretta, David; Di Giammatteo, Ugo

2013-04-01

The capability for long term preservation of earth science data is a key requirement to support on-going research and collaboration within and between many earth science disciplines. A number of critically important current research directions (e.g. understanding climate change, and ensuring sustainability of natural resources) rely on the preservation of data often collected over several decades in a form in which it can be accessed and used easily. Another key driver for strategic long term data preservation is that key research challenges (such as those described above) frequently require cross disciplinary research utilising raw and interpreted data from a number of earth science disciplines. Effective data preservation strategies can support this requirement for interoperability and collaboration, and thereby stimulate scientific innovation. The SCIDIP-ES project (EC FP7 grant agreement no. 283401) seeks to address these and other data preservation challenges by developing a Europe wide infrastructure for long term data preservation comprising appropriate software tools and infrastructure services to enable and promote long term preservation of earth science data. Because we define preservation in terms of continued usability of the digitally encoded information, the generic infrastructure services will allow a wide variety of data to be made usable by researchers from many different domains. This approach promotes international collaboration between researchers and will enable the cost for long-term usability across disciplines to be shared supporting the creation of strong business cases for the long term support of that data. This paper will describe our progress to date, including the results of community engagement and user consultation exercises designed to specify and scope the required tools and services. Our user engagement methodology, ensuring that we are capturing the views of a representative sample of institutional users, will be described. Key results of an in-depth user requirements exercise, and also the conclusions from a survey of existing technologies and policies for earth science data preservation involving almost five hundred respondents across Europe and beyond will also be outlined. A key aim of the project will also be to create harmonised data preservation and access policies for earth science data in Europe, taking into account the requirements of relevant earth science data users and archive providers across Europe, and liaising appropriately with other European data integration and e-infrastructure projects to ensure a collaborative strategy.

Clinical Trials | Division of Cancer Prevention

Cancer.gov

Information about actively enrolling, ongoing, and completed clinical trials of cancer prevention, early detection, and supportive care, including phase I, II, and III agent and action trials and clinical trials management. |

The US Support Program to IAEA Safeguards Priority of Training and Human Resources

DOE Office of Scientific and Technical Information (OSTI.GOV)

Queirolo,A.

2008-06-13

The U.S. Support Program to IAEA Safeguards (USSP) priority of training and human resources is aimed at providing the Department of Safeguards with an appropriate mixture of regular staff and extrabudgetary experts who are qualified to meet the IAEA's technical needs and to provide personnel with appropriate instruction to improve the technical basis and specific skills needed to perform their job functions. The equipment and methods used in inspection activities are unique, complex, and evolving. New and experienced safeguards inspectors need timely and effective training to perform required tasks and to learn new skills prescribed by new safeguards policies ormore » agreements. The role of the inspector has changed from that of strictly an accountant to include that of a detective. New safeguards procedures are being instituted, and therefore, experienced inspectors must be educated on these new procedures. The USSP also recognizes the need for training safeguards support staff, particularly those who maintain and service safeguards equipment (SGTS), and those who perform information collection and analysis (SGIM). The USSP is committed to supporting the IAEA with training to ensure the effectiveness of all staff members and will continue to offer its assistance in the development and delivery of basic, refresher, and advanced training courses. This paper will discuss the USSP ongoing support in the area of training and IAEA staffing.« less

The Ethical, Legal, and Social Implications Program of the National Human Genome Research Institute: reflections on an ongoing experiment.

PubMed

McEwen, Jean E; Boyer, Joy T; Sun, Kathie Y; Rothenberg, Karen H; Lockhart, Nicole C; Guyer, Mark S

2014-01-01

For more than 20 years, the Ethical, Legal, and Social Implications (ELSI) Program of the National Human Genome Research Institute has supported empirical and conceptual research to anticipate and address the ethical, legal, and social implications of genomics. As a component of the agency that funds much of the underlying science, the program has always been an experiment. The ever-expanding number of issues the program addresses and the relatively low level of commitment on the part of other funding agencies to support such research make setting priorities especially challenging. Program-supported studies have had a significant impact on the conduct of genomics research, the implementation of genomic medicine, and broader public policies. The program's influence is likely to grow as ELSI research, genomics research, and policy development activities become increasingly integrated. Achieving the benefits of increased integration while preserving the autonomy, objectivity, and intellectual independence of ELSI investigators presents ongoing challenges and new opportunities.

Social organization of self-management support of persons with diabetes: a health systems comparison.

PubMed

Schiøtz, Michaela; Frølich, Anne; Krasnik, Allan; Taylor, Warren; Hsu, John

2012-09-01

Identify important organizational elements for providing self-management support (SMS). Semi-structured qualitative interviews conducted in two healthcare systems. Kaiser Permanente Northern California and the Danish Health Care System. 36 managers and healthcare professionals in the two healthcare systems. Elements important to providing self-management support to persons with diabetes. Healthcare professionals' provision of SMS was influenced by healthcare system organization and their perceptions of SMS, the capability and responsibility of healthcare systems, and their roles in the healthcare organization. Enabling factors for providing SMS included: strong leadership; aligned incentives; use of an integrated health information technology (HIT) system; multidisciplinary healthcare provider teams; ongoing training for healthcare professionals; outreach; and quality goals. Barriers to providing SMS included lack of collaboration between providers and skeptical attitudes towards prevention and outreach. Implementation of SMS can be improved by an understanding of the elements that enhance its provision: (1) initiatives seeking to improve collaboration and integration between providers; (2) implementation of an integrated HIT system; and (3) ongoing training of healthcare professionals.

Determinants of Children's Mental Health in War-Torn Settings: Translating Research Into Action.

PubMed

Miller, Kenneth E; Jordans, Mark J D

2016-06-01

Research on the mental health and psychosocial wellbeing of children in conflict-affected settings has undergone a significant paradigm shift in recent years. Earlier studies based on a war exposure model primarily emphasized the effects of direct exposure to armed conflict; this has gradually given way to a broader understanding of the diverse pathways by which organized violence affects children. A robustly supported comprehensive model includes risk factors at multiple points in time (prior war exposure, ongoing daily stressors) and at all levels of the social ecology. In particular, findings suggest that material deprivation and a set of family variables, including harsh parenting, parental distress, and witnessing intimate partner violence, are important mediators of the relationship between armed conflict and children's wellbeing. To date, however, interventions aimed at supporting war-affected children's wellbeing, both preventive and treatment-focused, have focused primarily on direct work with children, while paying only modest attention to ongoing risk factors in their families and broader environments. Possible reasons for the ongoing prioritization of child-focused interventions are considered, and examples are provided of recent evidence-based interventions that have reduced toxic stressors (harsh parenting and the use of violent discipline by teachers) in conflict-affected communities.

Pulsed Out of Awareness: EEG Alpha Oscillations Represent a Pulsed-Inhibition of Ongoing Cortical Processing

PubMed Central

Mathewson, Kyle E.; Lleras, Alejandro; Beck, Diane M.; Fabiani, Monica; Ro, Tony; Gratton, Gabriele

2011-01-01

Alpha oscillations are ubiquitous in the brain, but their role in cortical processing remains a matter of debate. Recently, evidence has begun to accumulate in support of a role for alpha oscillations in attention selection and control. Here we first review evidence that 8–12 Hz oscillations in the brain have a general inhibitory role in cognitive processing, with an emphasis on their role in visual processing. Then, we summarize the evidence in support of our recent proposal that alpha represents a pulsed-inhibition of ongoing neural activity. The phase of the ongoing electroencephalography can influence evoked activity and subsequent processing, and we propose that alpha exerts its inhibitory role through alternating microstates of inhibition and excitation. Finally, we discuss evidence that this pulsed-inhibition can be entrained to rhythmic stimuli in the environment, such that preferential processing occurs for stimuli at predictable moments. The entrainment of preferential phase may provide a mechanism for temporal attention in the brain. This pulsed inhibitory account of alpha has important implications for many common cognitive phenomena, such as the attentional blink, and seems to indicate that our visual experience may at least some times be coming through in waves. PMID:21779257

34 CFR 363.6 - What definitions apply?

Code of Federal Regulations, 2010 CFR

2010-07-01

... for individuals with the most severe disabilities due to mental illness. (2) As used in the definition... to mental illness. In transitional employment, the provision of on-going support services must...

Better Decisions through Consultation and Collaboration

EPA Pesticide Factsheets

This manual discusses the benefits of public involvement to agency decision makers, including expanding shared baseline knowledge, generating support for the decision, and developing ongoing relationships that will help in implementing decisions.

Nurse practitioners and physician assistants: preparing new providers for hospital medicine at the mayo clinic.

PubMed

Spychalla, Megan T; Heathman, Joanne H; Pearson, Katherine A; Herber, Andrew J; Newman, James S

2014-01-01

Hospital medicine is a growing field with an increasing demand for additional healthcare providers, especially in the face of an aging population. Reductions in resident duty hours, coupled with a continued deficit of medical school graduates to appropriately meet the demand, require an additional workforce to counter the shortage. A major dilemma of incorporating nonphysician providers such as nurse practitioners and physician assistants (NPPAs) into a hospital medicine practice is their varying academic backgrounds and inpatient care experiences. Medical institutions seeking to add NPPAs to their hospital medicine practice need a structured orientation program and ongoing NPPA educational support. This article outlines an NPPA orientation and training program within the Division of Hospital Internal Medicine (HIM) at the Mayo Clinic in Rochester, MN. In addition to a practical orientation program that other institutions can model and implement, the division of HIM also developed supplemental learning modalities to maintain ongoing NPPA competencies and fill learning gaps, including a formal NPPA hospital medicine continuing medical education (CME) course, an NPPA simulation-based boot camp, and the first hospital-based NPPA grand rounds offering CME credit. Since the NPPA orientation and training program was implemented, NPPAs within the division of HIM have gained a reputation for possessing a strong clinical skill set coupled with a depth of knowledge in hospital medicine. The NPPA-physician model serves as an alternative care practice, and we believe that with the institution of modalities, including a structured orientation program, didactic support, hands-on learning, and professional growth opportunities, NPPAs are capable of fulfilling the gap created by provider shortages and resident duty hour restrictions. Additionally, the use of NPPAs in hospital medicine allows for patient care continuity that is otherwise missing with resident practice models.

The Regional Integrated Sciences and Assessments (RISA) Program, Climate Services, and Meeting the National Climate Change Adaptation Challenge

NASA Astrophysics Data System (ADS)

Overpeck, J. T.; Udall, B.; Miles, E.; Dow, K.; Anderson, C.; Cayan, D.; Dettinger, M.; Hartmann, H.; Jones, J.; Mote, P.; Ray, A.; Shafer, M.; White, D.

2008-12-01

The NOAA-led RISA Program has grown steadily to nine regions and a focus that includes both natural climate variability and human-driven climate change. The RISAs are, at their core, university-based and heavily invested in partnerships, particularly with stakeholders, NOAA, and other federal agencies. RISA research, assessment and partnerships have led to new operational climate services within NOAA and other agencies, and have become important foundations in the development of local, state and regional climate change adaptation initiatives. The RISA experience indicates that a national climate service is needed, and must include: (1) services prioritized based on stakeholder needs; (2) sustained, ongoing regional interactions with users, (3) a commitment to improve climate literacy; (4) support for assessment as an ongoing, iterative process; (5) full recognition that stakeholder decisions are seldom made using climate information alone; (6) strong interagency partnership; (7) national implementation and regional in focus; (8) capability spanning local, state, tribal, regional, national and international space scales, and weeks to millennia time scales; and (9) institutional design and scientific support flexible enough to assure the effort is nimble enough to respond to rapidly-changing stakeholder needs. The RISA experience also highlights the central role that universities must play in national climate change adaptation programs. Universities have a tradition of trusted regional stakeholder partnerships, as well as the interdisciplinary expertise - including social science, ecosystem science, law, and economics - required to meet stakeholder climate-related needs; project workforce can also shift rapidly in universities. Universities have a proven ability to build and sustain interagency partnerships. Universities excel in most forms of education and training. And universities often have proven entrepreneurship, technology transfer and private sector partnership capability.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Duncan, Joanne P.; Sackschewsky, Michael R.; Tilden, Harold T.

This report provides a synopsis of ongoing environmental management performance and compliance activities conducted during 2014, meeting the requirements of DOE Order 231.1B, Environmental, safety and health reporting.

Meningococcal Disease

MedlinePlus

... from UMass Amherst . Oregon State University Oregon State University (OSU) has an ongoing outbreak of serogroup B meningococcal disease. Students should check with OSU about requirements to get ...

Resilience: The Role of Optimism, Perceived Parental Autonomy Support and Perceived Social Support in First Year University Students

ERIC Educational Resources Information Center

Dawson, Michelle; Pooley, Julie Ann

2013-01-01

Throughout our lifespan we face many challenges which are often referred to as transitions. The move to university is one such transition which may place individuals at risk of suffering ongoing significant life stress, anxiety and uncertainty. Optimism, promotion of independent functioning (PIF), promotion of volitional functioning (PVF) and…

Using Narrative-Based Design Scaffolds within a Mobile Learning Environment to Support Learning Outdoors with Young Children

ERIC Educational Resources Information Center

Seely, Brian J.

2015-01-01

This study aims to advance learning outdoors with mobile devices. As part of the ongoing Tree Investigators design-based research study, this research investigated a mobile application to support observation, identification, and explanation of the tree life cycle within an authentic, outdoor setting. Recognizing the scientific and conceptual…

IN Like Flint: How the Innovation Incubator at UM-Flint Fosters Social Entrepreneurship in a City Remaking Itself

ERIC Educational Resources Information Center

Custer, Nic

2015-01-01

This paper focuses on how the University of Michigan-Flint's Innovation Incubator supports emerging for-profit businesses and nonprofit organizations through programming, business plan development, and ongoing mentorship. The Incubator is especially interested in supporting start-ups that address key social issues in the surrounding community,…

Supporting Concrete Visual Thinking in Multiplicative Reasoning: Difficulties and Opportunities. Technical Report 88-16.

ERIC Educational Resources Information Center

Kaput, James J.

The Educational Technology Center has attempted to develop a series of computer based learning environments to support the learning and application of multiplicative reasoning. The work and software described in this paper, including the teaching experiment that generated the error phenomena examined, is part of a larger ongoing research project.…

Investigating University Educators' Design Thinking and the Implications for Design Support Tools

ERIC Educational Resources Information Center

Bennett, Sue; Agostinho, Shirley; Lockyer, Lori

2016-01-01

All university educators perform design work as they prepare and plan learning experiences for their students. How such design work is undertaken, conceptualised, and optimally supported is the focus of ongoing research for the authors. The purpose of this article is to present the results of a research study that sought to gain a richer…

From Checklists to Heuristics: Designing MOOCs to Support Teacher Learning

ERIC Educational Resources Information Center

Brennan, Karen; Blum-Smith, Sarah; Yurkofsky, Maxwell M.

2018-01-01

Background: Although much is known from educational research about factors that support K-12 teacher professional learning, it has been an ongoing challenge to incorporate these factors into practice in new contexts and environments. We argue that these factors are too often treated like a checklist of discrete elements, either present or not,…

Guidelines for Evaluating Truancy Reduction Programs. Truancy Prevention in Action

ERIC Educational Resources Information Center

Wesley, Ted; Duttweiler, Patricia Cloud

2006-01-01

This monograph is intended as a guide to support self-evaluation of truancy reduction and prevention programs by those involved in their ongoing operations. It is one of four in a series addressing various aspects of truancy, was published by the National Dropout Prevention Center at Clemson University with support from the South Carolina…

75 FR 66767 - Submission for OMB Review; Comment Request; Cancer Trials Support Unit (CTSU) Public Use Forms...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-29

...; Comment Request; Cancer Trials Support Unit (CTSU) Public Use Forms and Customer Satisfaction Surveys (NCI...: CTSU collects annual surveys of customer satisfaction for clinical site staff using the CTSU Help Desk and the CTSU Web site. An ongoing user satisfaction survey is in place for the Oncology Patient...

75 FR 55586 - Submission for OMB Review; Comment Request Cancer Trials Support Unit (CTSU) Public Use Forms and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-13

...; Comment Request Cancer Trials Support Unit (CTSU) Public Use Forms and Customer Satisfaction Surveys (NCI... Collection: CTSU collects annual surveys of customer satisfaction for clinical site staff using the CTSU Help Desk and the CTSU Web site. An ongoing user satisfaction survey is in place for the Oncology Patient...

Call for NASA Mission Supporting Observations

NASA Astrophysics Data System (ADS)

Binzel, Richard P.

2018-04-01

Lightcurve observations are requested to support NASA missions planned for launch to study main-belt and Trojan asteroids. In some cases, the rotations of the target asteroids are unknown. In other cases, the periods are well established and ongoing measurements will deliver the precision needed to deduce the rotation phase at the time of encounter more than a decade away.

14 CFR 1216.305 - Actions requiring environmental assessments.

Code of Federal Regulations, 2013 CFR

2013-01-01

... prepare an EA. (b) Typical NASA actions normally requiring an EA include: (1) Specific spacecraft... altering the ongoing operations at a NASA Center which could lead directly, indirectly, or cumulatively to... solar system bodies (such as asteroids, comets, planets, dwarf planets, and planetary moons), which...

42 CFR 410.143 - Requirements for approved accreditation organizations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Diabetes Self-Management Training and Diabetes Outcome Measurements § 410.143 Requirements for approved... organization approved and recognized by CMS must undertake the following activities on an ongoing basis: (1... procedures: (1) Equivalency review. CMS compares the organization's standards and its application and...

The Art of Influencing Decision Makers.

ERIC Educational Resources Information Center

Diegmueller, Karen

1992-01-01

Influencing educational decision makers requires creating ongoing relationships, keeping everyone informed, and developing persuasive skills. Persuasion requires preparation, refinement, hard work, and a sound understanding of the people being lobbied. Lobbying must be factual and relevant to the audience. The article looks at influence from the…

International Space Station Increment-2 Quick Look Report

NASA Technical Reports Server (NTRS)

Jules, Kenol; Hrovat, Kenneth; Kelly, Eric

2001-01-01

The objective of this quick look report is to disseminate the International Space Station (ISS) Increment-2 reduced gravity environment preliminary analysis in a timely manner to the microgravity scientific community. This report is a quick look at the processed acceleration data collected by the Microgravity Acceleration Measurement System (MAMS) during the period of May 3 to June 8, 2001. The report is by no means an exhaustive examination of all the relevant activities, which occurred during the time span mentioned above for two reasons. First, the time span being considered in this report is rather short since the MAMS was not active throughout the time span being considered to allow a detailed characterization. Second, as the name of the report implied, it is a quick look at the acceleration data. Consequently, a more comprehensive report, the ISS Increment-2 report, will be published following the conclusion of the Increment-2 tour of duty. NASA sponsors the MAMS and the Space Acceleration Microgravity System (SAMS) to support microgravity science experiments, which require microgravity acceleration measurements. On April 19, 2001, both the MAMS and the SAMS units were launched on STS-100 from the Kennedy Space Center for installation on the ISS. The MAMS unit was flown to the station in support of science experiments requiring quasisteady acceleration data measurements, while the SAMS unit was flown to support experiments requiring vibratory acceleration data measurement. Both acceleration systems are also used in support of the vehicle microgravity requirements verification. The ISS reduced gravity environment analysis presented in this report uses mostly the MAMS acceleration data measurements (the Increment-2 report will cover both systems). The MAMS has two sensors. The MAMS Orbital Acceleration Research Experiment Sensor Subsystem, which is a low frequency range sensor (up to 1 Hz), is used to characterize the quasi-steady environment for payloads and vehicle. The MAMS High Resolution Acceleration Package is used to characterize the ISS vibratory environment up to 100 Hz. This quick look report presents some selected quasi-steady and vibratory activities recorded by the MAMS during the ongoing ISS Increment-2 tour of duty.

Nature and frequency of services provided by child and family health nurses in Australia: results of a national survey.

PubMed

Schmied, Virginia; Fowler, Cathrine; Rossiter, Chris; Homer, Caroline; Kruske, Sue

2014-05-01

Australia has a system of universal child and family health (CFH) nursing services providing primary health services from birth to school entry. Herein, we report on the findings of the first national survey of CFH nurses, including the ages and circumstances of children and families seen by CFH nurses and the nature and frequency of the services provided by these nurses across Australia. A national survey of CFH nurses was conducted. In all, 1098 CFH nurses responded to the survey. Over 60% were engaged in delivering primary prevention services from a universal platform. Overall, 82.8% reported that their service made first contact with families within 2 weeks of birth, usually in the home (80.7%). The proportion of respondents providing regular support to families decreased as the child aged. Services were primarily health centre based, although 25% reported providing services in other locations (parks, preschools).The timing and location of first contact, the frequency of ongoing services and the composition of families seen by nurses varied across Australian jurisdictions. Nurses identified time constraints as the key barrier to the delivery of comprehensive services. CFH nurses play an important role in supporting families across Australia. The impact of differences in the CFH nursing provision across Australia requires further investigation. What is known about the topic? Countries that offer universal well child health services demonstrate better child health and developmental outcomes than countries that do not. Australian jurisdictions offer free, universal child and family health (CFH) nursing services from birth to school entry. What does this paper add? This paper provides nation-wide data on the nature of work undertaken by CFH nurses offering universal care. Across Australia, there are differences in the timing and location of first contact, the frequency of ongoing services and the range of families seen by nurses. What are the implications for practitioners? The impact for families of the variation in CFH nursing services offered across Australia is not known. Further research is required to investigate the outcomes of the service provision variations identified in the present study.

Implementation of Epic Beaker Anatomic Pathology at an Academic Medical Center.

PubMed

Blau, John Larry; Wilford, Joseph D; Dane, Susan K; Karandikar, Nitin J; Fuller, Emily S; Jacobsmeier, Debbie J; Jans, Melissa A; Horning, Elisabeth A; Krasowski, Matthew D; Ford, Bradley A; Becker, Kent R; Beranek, Jeanine M; Robinson, Robert A

2017-01-01

Beaker is a relatively new laboratory information system (LIS) offered by Epic Systems Corporation as part of its suite of health-care software and bundled with its electronic medical record, EpicCare. It is divided into two modules, Beaker anatomic pathology (Beaker AP) and Beaker Clinical Pathology. In this report, we describe our experience implementing Beaker AP version 2014 at an academic medical center with a go-live date of October 2015. This report covers preimplementation preparations and challenges beginning in September 2014, issues discovered soon after go-live in October 2015, and some post go-live optimizations using data from meetings, debriefings, and the project closure document. We share specific issues that we encountered during implementation, including difficulties with the proposed frozen section workflow, developing a shared specimen source dictionary, and implementation of the standard Beaker workflow in large institution with trainees. We share specific strategies that we used to overcome these issues for a successful Beaker AP implementation. Several areas of the laboratory-required adaptation of the default Beaker build parameters to meet the needs of the workflow in a busy academic medical center. In a few areas, our laboratory was unable to use the Beaker functionality to support our workflow, and we have continued to use paper or have altered our workflow. In spite of several difficulties that required creative solutions before go-live, the implementation has been successful based on satisfaction surveys completed by pathologists and others who use the software. However, optimization of Beaker workflows has continued to be an ongoing process after go-live to the present time. The Beaker AP LIS can be successfully implemented at an academic medical center but requires significant forethought, creative adaptation, and continued shared management of the ongoing product by institutional and departmental information technology staff as well as laboratory managers to meet the needs of the laboratory.

Targeting oncogenic vulnerabilities in triple negative breast cancer: biological bases and ongoing clinical studies

PubMed Central

Ocana, Alberto; Pandiella, Atanasio

2017-01-01

Triple negative breast cancer (TNBC) is still an incurable disease despite the great scientific effort performed during the last years. The huge heterogeneity of this disease has motivated the evaluation of a great number of therapies against different molecular alterations. In this article, we review the biological bases of this entity and how the known molecular evidence supports the current preclinical and clinical development of new therapies. Special attention will be given to ongoing clinical studies and potential options for future drug combinations. PMID:28108739

Community-supported models of care for people on HIV treatment in sub-Saharan Africa.

PubMed

Bemelmans, Marielle; Baert, Saar; Goemaere, Eric; Wilkinson, Lynne; Vandendyck, Martin; van Cutsem, Gilles; Silva, Carlota; Perry, Sharon; Szumilin, Elisabeth; Gerstenhaber, Rodd; Kalenga, Lucien; Biot, Marc; Ford, Nathan

2014-08-01

Further scale-up of antiretroviral therapy (ART) to those in need while supporting the growing patient cohort on ART requires continuous adaptation of healthcare delivery models. We describe several approaches to manage stable patients on ART developed by Médecins Sans Frontières together with Ministries of Health in four countries in sub-Saharan Africa. Using routine programme data, four approaches to simplify ART delivery for stable patients on ART were assessed from a patient and health system perspective: appointment spacing for clinical and drug refill visits in Malawi, peer educator-led ART refill groups in South Africa, community ART distribution points in DRC and patient-led community ART groups in Mozambique. All four approaches lightened the burden for both patients (reduced travel and lost income) and health system (reduced clinic attendance). Retention in care is high: 94% at 36 months in Malawi, 89% at 12 months in DRC, 97% at 40 months in South Africa and 92% at 48 months in Mozambique. Where evaluable, service provider costs are reported to be lower. Separating ART delivery from clinical assessments was found to benefit patients and programmes in a range of settings. The success of community ART models depends on sufficient and reliable support and resources, including a flexible and reliable drug supply, access to quality clinical management, a reliable monitoring system and a supported lay workers cadre. Such models require ongoing evaluation and further adaptation to be able to reach out to more patients, including specific groups who may be challenged to meet the demands of frequent clinic visits and the integrated delivery of other essential chronic disease interventions. © 2014 John Wiley & Sons Ltd.

Development of practice principles for the management of ongoing suicidal ideation in young people diagnosed with major depressive disorder.

PubMed

Rice, Simon M; Simmons, Magenta B; Bailey, Alan P; Parker, Alexandra G; Hetrick, Sarah E; Davey, Christopher G; Phelan, Mark; Blaikie, Simon; Edwards, Jane

2014-01-01

There is a lack of clear guidance regarding the management of ongoing suicidality in young people experiencing major depressive disorder. This study utilised an expert consensus approach in identifying practice principles to complement relevant clinical guidelines for the treatment of major depressive disorder in young people. The study also sought to outline a broad treatment framework for clinical intervention with young people experiencing ongoing suicidal ideation. In-depth focus groups were undertaken with a specialist multidisciplinary clinical team (the Youth Mood Clinic at Orygen Youth Health Clinical Program, Melbourne) working with young people aged 15-25 years experiencing ongoing suicidal ideation. Each focus group was audio recorded and transcribed verbatim using orthographic conventions. Principles of grounded theory and thematic analysis were used to analyse and code the resultant data. The identified codes were subsequently synthesised into eight practice principles reflecting engagement and consistency of care, ongoing risk assessment and documentation, individualised crisis planning, engaging systems of support, engendering hopefulness, development of adaptive coping, management of acute risk, and consultation and supervision. The identified practice principles provide a broad management framework, and may assist to improve treatment consistency and clinical management of young people experiencing ongoing suicidal ideation. The practice principles may be of use to health professionals working within a team-based setting involved in the provision of care, even if peripherally, to young people with ongoing suicidal ideation. Findings address the lack of treatment consistency and shared terminology and may provide containment and guidance to multidisciplinary clinicians working with this at-risk group.

Data-driven backward chaining

NASA Technical Reports Server (NTRS)

Haley, Paul

1991-01-01

The C Language Integrated Production System (CLIPS) cannot effectively perform sound and complete logical inference in most real-world contexts. The problem facing CLIPS is its lack of goal generation. Without automatic goal generation and maintenance, forward chaining can only deduce all instances of a relationship. Backward chaining, which requires goal generation, allows deduction of only that subset of what is logically true which is also relevant to ongoing problem solving. Goal generation can be mimicked in simple cases using forward chaining. However, such mimicry requires manual coding of additional rules which can assert an inadequate goal representation for every condition in every rule that can have corresponding facts derived by backward chaining. In general, for N rules with an average of M conditions per rule the number of goal generation rules required is on the order of N*M. This is clearly intractable from a program maintenance perspective. We describe the support in Eclipse for backward chaining which it automatically asserts as it checks rule conditions. Important characteristics of this extension are that it does not assert goals which cannot match any rule conditions, that 2 equivalent goals are never asserted, and that goals persist as long as, but no longer than, they remain relevant.

Management strategies in pancreatic cancer.

PubMed

Campen, Christopher J; Dragovich, Tomislav; Baker, Amanda F

2011-04-01

Current first-line and adjuvant chemotherapeutic strategies for management of patients with pancreatic cancer are reviewed. Pancreatic adenocarcinoma is the 10th most prevalent cancer and the fourth most common cause of cancer deaths in the United States. More than 80% of patients with pancreatic cancer are diagnosed with locally advanced or metastatic disease and are not candidates for surgery; these patients often require multimodal treatment. The most widely used chemotherapy for such patients, as well as patients requiring adjuvant therapy after surgery, is gemcitabine or gemcitabine-based chemotherapy. All current chemotherapies for pancreatic cancer are associated with dose-limiting hematologic toxicity and other adverse effects that require ongoing monitoring and dosage adjustment to balance the benefits and risks of treatment. Pharmacists can play an important role in monitoring and providing drug information and guidance to patients and oncologists. Current investigational strategies include efforts to improve chemotherapy response rates and outcomes through modulation of cell signaling pathways and use of nanotechnology to improve drug delivery. Current management of pancreatic cancer is multifaceted, involving anticancer therapy, supportive care, and toxicity management. Standard systemic therapy with gemcitabine as a single agent or in combination with other cytotoxic agents provides modest benefits in terms of response and symptom control.

Faculty Engagement with Integrative Assignment Design: Connecting Teaching and Assessment

ERIC Educational Resources Information Center

Green, Kimberly; Hutchings, Pat

2018-01-01

Building on an initiative of the National Institute for Learning Outcomes Assessment, Washington State University faculty have worked to develop more effective integrative capstone assignments in ways that support ongoing improvement.

Analytic innovations for air quality modeling

EPA Science Inventory

The presentation provides an overview of ongoing research activities at the U.S. EPA, focusing on improving long-term emission projections and the development of decision support systems for coordinated environmental, climate and energy planning.

Fatigue testing of galvanized and ungalvanized socket connections.

DOT National Transportation Integrated Search

2014-09-01

The fatigue resistance of welded traffic signal support structure details is an ongoing research topic being : addressed at multiple universities primarily through state funding mechanisms. Fatigue problems with these : structures have plagued multip...

Implementation of a Personnel Reliability Program as a Facilitator of Biosafety and Biosecurity Culture in BSL-3 and BSL-4 Laboratories

PubMed Central

Weaver, Patrick; Fitch, J. Patrick; Johnson, Barbara; Pearl, R. Marene

2013-01-01

In late 2010, the National Biodefense Analysis and Countermeasures Center (NBACC) implemented a Personnel Reliability Program (PRP) with the goal of enabling active participation by its staff to drive and improve the biosafety and biosecurity culture at the organization. A philosophical keystone for accomplishment of NBACC's scientific mission is simultaneous excellence in operations and outreach. Its personnel reliability program builds on this approach to: (1) enable and support a culture of responsibility based on human performance principles, (2) maintain compliance with regulations, and (3) address the risk associated with the insider threat. Recently, the Code of Federal Regulations (CFR) governing use and possession of biological select agents and toxins (BSAT) was amended to require a pre-access suitability assessment and ongoing evaluation for staff accessing Tier 1 BSAT. These 2 new requirements are in addition to the already required Federal Bureau of Investigation (FBI) Security Risk Assessment (SRA). Two years prior to the release of these guidelines, NBACC developed its PRP to supplement the SRA requirement as a means to empower personnel and foster an operational environment where any and all work with BSAT is conducted in a safe, secure, and reliable manner. PMID:23745523

Mechanisms and Effects of Transcranial Direct Current Stimulation

PubMed Central

Giordano, James; Bikson, Marom; Kappenman, Emily S.; Clark, Vincent P.; Coslett, H. Branch; Hamblin, Michael R.; Hamilton, Roy; Jankord, Ryan; Kozumbo, Walter J.; McKinley, R. Andrew; Nitsche, Michael A.; Reilly, J. Patrick; Richardson, Jessica; Wurzman, Rachel

2017-01-01

The US Air Force Office of Scientific Research convened a meeting of researchers in the fields of neuroscience, psychology, engineering, and medicine to discuss most pressing issues facing ongoing research in the field of transcranial direct current stimulation (tDCS) and related techniques. In this study, we present opinions prepared by participants of the meeting, focusing on the most promising areas of research, immediate and future goals for the field, and the potential for hormesis theory to inform tDCS research. Scientific, medical, and ethical considerations support the ongoing testing of tDCS in healthy and clinical populations, provided best protocols are used to maximize safety. Notwithstanding the need for ongoing research, promising applications include enhancing vigilance/attention in healthy volunteers, which can accelerate training and support learning. Commonly, tDCS is used as an adjunct to training/rehabilitation tasks with the goal of leftward shift in the learning/treatment effect curves. Although trials are encouraging, elucidating the basic mechanisms of tDCS will accelerate validation and adoption. To this end, biomarkers (eg, clinical neuroimaging and findings from animal models) can support hypotheses linking neurobiological mechanisms and behavioral effects. Dosage can be optimized using computational models of current flow and understanding dose–response. Both biomarkers and dosimetry should guide individualized interventions with the goal of reducing variability. Insights from other applied energy domains, including ionizing radiation, transcranial magnetic stimulation, and low-level laser (light) therapy, can be prudently leveraged. PMID:28210202

Time course of ongoing activity during neuritis and following axonal transport disruption.

PubMed

Satkeviciute, Ieva; Goodwin, George; Bove, Geoffrey M; Dilley, Andrew

2018-05-01

Local nerve inflammation (neuritis) leads to ongoing activity and axonal mechanical sensitivity (AMS) along intact nociceptor axons and disrupts axonal transport. This phenomenon forms the most feasible cause of radiating pain, such as sciatica. We have previously shown that axonal transport disruption without inflammation or degeneration also leads to AMS but does not cause ongoing activity at the time point when AMS occurs, despite causing cutaneous hypersensitivity. However, there have been no systematic studies of ongoing activity during neuritis or noninflammatory axonal transport disruption. In this study, we present the time course of ongoing activity from primary sensory neurons following neuritis and vinblastine-induced axonal transport disruption. Whereas 24% of C/slow Aδ-fiber neurons had ongoing activity during neuritis, few (<10%) A- and C-fiber neurons showed ongoing activity 1-15 days following vinblastine treatment. In contrast, AMS increased transiently at the vinblastine treatment site, peaking on days 4-5 (28% of C/slow Aδ-fiber neurons) and resolved by day 15. Conduction velocities were slowed in all groups. In summary, the disruption of axonal transport without inflammation does not lead to ongoing activity in sensory neurons, including nociceptors, but does cause a rapid and transient development of AMS. Because it is proposed that AMS underlies mechanically induced radiating pain, and a transient disruption of axonal transport (as previously reported) leads to transient AMS, it follows that processes that disrupt axonal transport, such as neuritis, must persist to maintain AMS and the associated symptoms. NEW & NOTEWORTHY Many patients with radiating pain lack signs of nerve injury on clinical examination but may have neuritis, which disrupts axonal transport. We have shown that axonal transport disruption does not induce ongoing activity in primary sensory neurons but does cause transient axonal mechanical sensitivity. The present data complete a profile of key axonal sensitivities following axonal transport disruption. Collectively, this profile supports that an active peripheral process is necessary for maintained axonal sensitivities.

Asthma Quiz

MedlinePlus

... Asthma is a chronic disease that requires ongoing management. Personalized plans for treatment may include medications, an asthma action plan, and environmental control measures to avoid your child's asthma triggers. ...

How to Cut Landscape Maintenance Costs.

ERIC Educational Resources Information Center

Brickman, Dick

1982-01-01

A landscape architect explains how maintenance requirements and costs are affected by landscape design, the physical demands of the site, and the relative use of grass, ground cover, shrubs, and trees. The relationship of these factors to initial and ongoing maintenance costs, including staff requirements, is discussed. (MLF)

14 CFR § 1216.305 - Actions requiring environmental assessments.

Code of Federal Regulations, 2014 CFR

2014-01-01

... prepare an EA. (b) Typical NASA actions normally requiring an EA include: (1) Specific spacecraft... altering the ongoing operations at a NASA Center which could lead directly, indirectly, or cumulatively to... solar system bodies (such as asteroids, comets, planets, dwarf planets, and planetary moons), which...

Remotely-supervised transcranial direct current stimulation (tDCS) for clinical trials: guidelines for technology and protocols.

PubMed

Charvet, Leigh E; Kasschau, Margaret; Datta, Abhishek; Knotkova, Helena; Stevens, Michael C; Alonzo, Angelo; Loo, Colleen; Krull, Kevin R; Bikson, Marom

2015-01-01

The effect of transcranial direct current stimulation (tDCS) is cumulative. Treatment protocols typically require multiple consecutive sessions spanning weeks or months. However, traveling to clinic for a tDCS session can present an obstacle to subjects and their caregivers. With modified devices and headgear, tDCS treatment can be administered remotely under clinical supervision, potentially enhancing recruitment, throughput, and convenience. Here we propose standards and protocols for clinical trials utilizing remotely-supervised tDCS with the goal of providing safe, reproducible and well-tolerated stimulation therapy outside of the clinic. The recommendations include: (1) training of staff in tDCS treatment and supervision; (2) assessment of the user's capability to participate in tDCS remotely; (3) ongoing training procedures and materials including assessments of the user and/or caregiver; (4) simple and fail-safe electrode preparation techniques and tDCS headgear; (5) strict dose control for each session; (6) ongoing monitoring to quantify compliance (device preparation, electrode saturation/placement, stimulation protocol), with corresponding corrective steps as required; (7) monitoring for treatment-emergent adverse effects; (8) guidelines for discontinuation of a session and/or study participation including emergency failsafe procedures tailored to the treatment population's level of need. These guidelines are intended to provide a minimal level of methodological rigor for clinical trials seeking to apply tDCS outside a specialized treatment center. We outline indication-specific applications (Attention Deficit Hyperactivity Disorder, Depression, Multiple Sclerosis, Palliative Care) following these recommendations that support a standardized framework for evaluating the tolerability and reproducibility of remote-supervised tDCS that, once established, will allow for translation of tDCS clinical trials to a greater size and range of patient populations.

3D Surveying, Modeling and Geo-Information System of the New Campus of ITB-Indonesia

NASA Astrophysics Data System (ADS)

Suwardhi, D.; Trisyanti, S. W.; Ainiyah, N.; Fajri, M. N.; Hanan, H.; Virtriana, R.; Edmarani, A. A.

2016-10-01

The new campus of ITB-Indonesia, which is located at Jatinangor, requires good facilities and infrastructures to supporting all of campus activities. Those can not be separated from procurement and maintenance activities. Technology for procurement and maintenance of facilities and infrastructures -based computer (information system)- has been known as Building Information Modeling (BIM). Nowadays, that technology is more affordable with some of free software that easy to use and tailored to user needs. BIM has some disadvantages and it requires other technologies to complete it, namely Geographic Information System (GIS). BIM and GIS require surveying data to visualized landscape and buildings on Jatinangor ITB campus. This paper presents the on-going of an internal service program conducted by the researcher, academic staff and students for the university. The program including 3D surveying to support the data requirements for 3D modeling of buildings in CityGML and Industry Foundation Classes (IFC) data model. The entire 3D surveying will produce point clouds that can be used to make 3D model. The 3D modeling is divided into low and high levels of detail modeling. The low levels model is stored in 3D CityGML database, and the high levels model including interiors is stored in BIM Server. 3D model can be used to visualized the building and site of Jatinangor ITB campus. For facility management of campus, an geo-information system is developed that can be used for planning, constructing, and maintaining Jatinangor ITB's facilities and infrastructures. The system uses openMAINT, an open source solution for the Property & Facility Management.

Extraterrestrial Hemorrhage Control: Terrestrial Developments in Technique, Technology, and Philosophy with Applicability to Traumatic Hemorrhage in Space

NASA Technical Reports Server (NTRS)

Kirkpatrick, Andrew; Dawson, David; Campbell, Mark; Jones, Jeff; Ball, Chad G.; Hamilton, Douglas R.; Dulchavsky, Scott; McBeth, Paul; Holcomb, John

2004-01-01

Managing injury and illness during long duration space flight limits efforts to explore beyond low earths orbit. Traumatic injury may be expected to occur in space and is a frequent cause of preventable deaths, often related to uncontrolled or ongoing hemorrhage (H). Such bleeding causes 40% of terrestrial injury mortality. Current guidelines emphasize early control of H compared to intravenous infusions. Recent advances in surgical and critical care may be applicable to trauma care in space, with appropriate considerations of the extreme logistical and personnel limitations. Methods: Recent developments in technique, resuscitation fluids, hemoglobin (Hb) substitutes, hemostatic agents, interventional angiography, damage control principles, and concepts related to suspended animation were reviewed. Results: H associated with instability frequently requires definitive intervention. Direct pressure should be applied to all compressible bleeding, but novel approaches are required for intracavitary noncompressible bleeding. Intravenous hemostatic agents such as recombinant Factor VII may facilitate hemostasis especially when combined with a controlled hypotension approach. Both open and laparoscopic techniques could be used in weightlessness, but require technical expertise not likely to be available. Specific rehearsed invasive techniques such as laparotomy with packing, or arterial catherterization with with robotic intravascular embolization might be considered . Hemodynamic support, thermal manipulation, or pharmacologic induction of a state of metabolic down regulation for whole body preservation may be appropriate. Hypertonic saline, with or without dextran, may temporize vascular support and decrease reperfusion injury, with less mass than other solutions. Hb substitutes have other theoretical advantages. Conclusions: Terrestrial developments suggest potential novel strategies to control H in space, but will required a coordinated program of evaluation and training to evaluate.

Oxytocin and Aggression.

PubMed

de Jong, Trynke R; Neumann, Inga D

2017-09-02

The neuropeptide oxytocin (OT) has a solid reputation as a facilitator of social interactions such as parental and pair bonding, trust, and empathy. The many results supporting a pro-social role of OT have generated the hypothesis that impairments in the endogenous OT system may lead to antisocial behavior, most notably social withdrawal or pathological aggression. If this is indeed the case, administration of exogenous OT could be the "serenic" treatment that psychiatrists have for decades been searching for.In the present review, we list and discuss the evidence for an endogenous "hypo-oxytocinergic state" underlying aggressive and antisocial behavior, derived from both animal and human studies. We furthermore examine the reported effects of synthetic OT administration on aggression in rodents and humans.Although the scientific findings listed in this review support, in broad lines, the link between a down-regulated or impaired OT system activity and increased aggression, the anti-aggressive effects of synthetic OT are less straightforward and require further research. The rather complex picture that emerges adds to the ongoing debate questioning the unidirectional pro-social role of OT, as well as the strength of the effects of intranasal OT administration in humans.

Extending the NIF DISCO framework to automate complex workflow: coordinating the harvest and integration of data from diverse neuroscience information resources

PubMed Central

Marenco, Luis N.; Wang, Rixin; Bandrowski, Anita E.; Grethe, Jeffrey S.; Shepherd, Gordon M.; Miller, Perry L.

2014-01-01

This paper describes how DISCO, the data aggregator that supports the Neuroscience Information Framework (NIF), has been extended to play a central role in automating the complex workflow required to support and coordinate the NIF’s data integration capabilities. The NIF is an NIH Neuroscience Blueprint initiative designed to help researchers access the wealth of data related to the neurosciences available via the Internet. A central component is the NIF Federation, a searchable database that currently contains data from 231 data and information resources regularly harvested, updated, and warehoused in the DISCO system. In the past several years, DISCO has greatly extended its functionality and has evolved to play a central role in automating the complex, ongoing process of harvesting, validating, integrating, and displaying neuroscience data from a growing set of participating resources. This paper provides an overview of DISCO’s current capabilities and discusses a number of the challenges and future directions related to the process of coordinating the integration of neuroscience data within the NIF Federation. PMID:25018728

Cultural adaptation of a supportive care needs measure for Hispanic men cancer survivors.

PubMed

Martinez Tyson, Dinorah; Medina-Ramirez, Patricia; Vázquez-Otero, Coralia; Gwede, Clement K; Bobonis, Margarita; McMillan, Susan C

2018-01-01

Research with ethnic minority populations requires instrumentation that is cultural and linguistically relevant. The aim of this study was to translate and culturally adapt the Cancer Survivor Unmet Needs measure into Spanish. We describe the iterative, community-engaged consensus-building approaches used to adapt the instrument for Hispanic male cancer survivors. We used an exploratory sequential mixed method study design. Methods included translation and back-translation, focus groups with cancer survivors (n = 18) and providers (n = 5), use of cognitive interview techniques to evaluate the comprehension and acceptability of the adapted instrument with survivors (n = 12), ongoing input from the project's community advisory board, and preliminary psychometric analysis (n = 84). The process emphasized conceptual, content, semantic, and technical equivalence. Combining qualitative and quantitative approaches offered a rigorous, systematic, and contextual approach to translation alone and supports the cultural adaptation of this measure in a purposeful and relevant manner. Our findings highlight the importance of going beyond translation when adapting measures for cross-cultural populations and illustrate the importance of taking culture, literacy, and language into consideration.

Community Management That Works: How to Build and Sustain a Thriving Online Health Community

PubMed Central

2013-01-01

Health care professionals, patients, caregivers, family, friends, and other supporters are increasingly joining online health communities to share information and find support. But social Web (Web 2.0) technology alone does not create a successful online community. Building and sustaining a successful community requires an enabler and strategic community management. Community management is more than moderation. The developmental life cycle of a community has four stages: inception, establishment, maturity, and mitosis. Each stage presents distinct characteristics and management needs. This paper describes the community management strategies, resources, and expertise needed to build and maintain a thriving online health community; introduces some of the challenges; and provides a guide for health organizations considering this undertaking. The paper draws on insights from an ongoing study and observation of online communities as well as experience managing and consulting a variety of online health communities. Discussion includes effective community building practices relevant to each stage, such as outreach and relationship building, data collection, content creation, and other proven techniques that ensure the survival and steady growth of an online health community. PMID:23759312

Extending the NIF DISCO framework to automate complex workflow: coordinating the harvest and integration of data from diverse neuroscience information resources.

PubMed

Marenco, Luis N; Wang, Rixin; Bandrowski, Anita E; Grethe, Jeffrey S; Shepherd, Gordon M; Miller, Perry L

2014-01-01

This paper describes how DISCO, the data aggregator that supports the Neuroscience Information Framework (NIF), has been extended to play a central role in automating the complex workflow required to support and coordinate the NIF's data integration capabilities. The NIF is an NIH Neuroscience Blueprint initiative designed to help researchers access the wealth of data related to the neurosciences available via the Internet. A central component is the NIF Federation, a searchable database that currently contains data from 231 data and information resources regularly harvested, updated, and warehoused in the DISCO system. In the past several years, DISCO has greatly extended its functionality and has evolved to play a central role in automating the complex, ongoing process of harvesting, validating, integrating, and displaying neuroscience data from a growing set of participating resources. This paper provides an overview of DISCO's current capabilities and discusses a number of the challenges and future directions related to the process of coordinating the integration of neuroscience data within the NIF Federation.

Enhanced stability and polyadenylation of select mRNAs support rapid thermogenesis in the brown fat of a hibernator

PubMed Central

Grabek, Katharine R; Diniz Behn, Cecilia; Barsh, Gregory S; Hesselberth, Jay R; Martin, Sandra L

2015-01-01

During hibernation, animals cycle between torpor and arousal. These cycles involve dramatic but poorly understood mechanisms of dynamic physiological regulation at the level of gene expression. Each cycle, Brown Adipose Tissue (BAT) drives periodic arousal from torpor by generating essential heat. We applied digital transcriptome analysis to precisely timed samples to identify molecular pathways that underlie the intense activity cycles of hibernator BAT. A cohort of transcripts increased during torpor, paradoxical because transcription effectively ceases at these low temperatures. We show that this increase occurs not by elevated transcription but rather by enhanced stabilization associated with maintenance and/or extension of long poly(A) tails. Mathematical modeling further supports a temperature-sensitive mechanism to protect a subset of transcripts from ongoing bulk degradation instead of increased transcription. This subset was enriched in a C-rich motif and genes required for BAT activation, suggesting a model and mechanism to prioritize translation of key proteins for thermogenesis. DOI: http://dx.doi.org/10.7554/eLife.04517.001 PMID:25626169

The effectiveness of Teratology Information Services (TIS).

PubMed

Hancock, Rebecca L; Koren, Gideon; Einarson, Adrienne; Ungar, Wendy J

2007-02-01

Women and their health care providers have few reliable sources of information regarding the safety of exposures in pregnancy and lactation. Evidence-based information on these topics is provided by Teratology Information Services (TIS). Access to TIS, however, is limited in many regions, and many services have difficulty maintaining ongoing funding. The objective of this review is to highlight published reports of the effectiveness of TIS in improving maternal and neonatal health. A search of the Pub Med and Econ Lit databases was performed with no date restriction, using the search terms teratology, information, counseling, pregnancy, effectiveness, birth defects. Information disseminated from TIS has been shown to prevent congenital malformations, unnecessary pregnancy terminations, and occupational risks. TIS support optimal nutritional supplementation in pregnancy and optimal drug therapy in pregnancy and breast-feeding. In addition, they correct misperceptions of risk and facilitate knowledge transfer and translation. TIS have the potential to provide health care cost savings. TIS are vital services in supporting optimal maternal and neonatal health. A formal economic evaluation of TIS is required in order to inform resource allocation decision-making and continued funding of these services.

The role of health promotion: between global thinking and local action.

PubMed

King, Lesley

2006-12-01

The persistence of health inequities provides an ongoing challenge for health promotion. The dictum 'think globally, act locally' fails to recognise the significance of infrastructure and policy in linking global issues and local practices as a means of addressing health inequities. Commentary and opinion. Through analytic tools and methods, health promotion has much to contribute to facilitating health-improving changes in social, economic and physical environments. Local actions provide excellent illustrations of organisational change and intersectoral action, and present the possibility that such actions could be widely implemented. While this has occurred on some issues, this is not usually the case. Political support, policy and infrastructure are required to link global ideas and local actions and overcome the impasse. Media advocacy is one example of an approach with potential to make these links and mobilise political support. Reframing media and political discussion, away from the dichotomy of individual responsibility and government intervention and towards acknowledging the social context of human behaviour, could contribute to policy and social environments with greater capacity to address inequities.

The role of the charge nurse manager: a descriptive exploratory study.

PubMed

McCallin, A M; Frankson, C

2010-04-01

To explore the charge nurse manager role. Management in nursing is increasingly challenging. Restructuring of organizations has had an impact on the scope of the charge nurse manager role that has expanded so that managers are now expected to be leaders. If role preparation is inadequate, potential for role confusion and role stress increases, undermining role effectiveness in this key senior nursing position. This descriptive exploratory study investigated the experiences of charge nurse managers. Twelve nurse managers from an acute care hospital in New Zealand were interviewed. Data were analysed thematically. Three themes, role ambiguity, business management deficit and role overload emerged. It was evident that charge nurse managers were appointed into a management role with clinical expertise but without management skills. Findings suggest that role preparation should include postgraduate education and business management training. Role induction requires a formal organizational management trainee programme and ongoing supportive clinical supervision. New approaches to charge nurse manager role development are needed. Organizations must provide formal structural support to facilitate management development. The profession needs to promote succession planning that would reduce these longstanding problems.

Effective behavioral modeling and prediction even when few exemplars are available

NASA Astrophysics Data System (ADS)

Goan, Terrance; Kartha, Neelakantan; Kaneshiro, Ryan

2006-05-01

While great progress has been made in the lowest levels of data fusion, practical advances in behavior modeling and prediction remain elusive. The most critical limitation of existing approaches is their inability to support the required knowledge modeling and continuing refinement under realistic constraints (e.g., few historic exemplars, the lack of knowledge engineering support, and the need for rapid system deployment). This paper reports on our ongoing efforts to develop Propheteer, a system which will address these shortcomings through two primary techniques. First, with Propheteer we abandon the typical consensus-driven modeling approaches that involve infrequent group decision making sessions in favor of an approach that solicits asynchronous knowledge contributions (in the form of alternative future scenarios and indicators) without burdening the user with endless certainty or probability estimates. Second, we enable knowledge contributions by personnel beyond the typical core decision making group, thereby casting light on blind spots, mitigating human biases, and helping maintain the currency of the developed behavior models. We conclude with a discussion of the many lessons learned in the development of our prototype Propheteer system.

NASA Space Cryocooler Programs: A 2003 Overview

NASA Technical Reports Server (NTRS)

Ross, R. G., Jr.; Boyle, R. F.; Kittel, P.

2004-01-01

Mechanical cryocoolers represent a significant enabling technology for NASA's Earth and Space Science missions. An overview is presented of ongoing cryocooler activities within NASA in support of current flight projects, near-term flight instruments, and long-term technology development. NASA programs in Earth and space science observe a wide range of phenomena, from crop dynamics to stellar birth. Many of the instruments require cryogenic refrigeration to improve dynamic range, extend wavelength coverage, and enable the use of advanced detectors. Although, the largest utilization of coolers over the last decade has been for instruments operating at medium to high cryogenic temperatures (55 to 150 K), reflecting the relative maturity of the technology at these temperatures, important new developments are now focusing at the lower temperature range from 4 to 20 K in support of studies of the origin of the universe and the search for planets around distant stars. NASA's development of a 20K cryocooler for the European Planck spacecraft and its new Advanced Cryocooler Technology Development Program (ACTDP) for 6-18 K coolers are examples of the thrust to provide low temperature cooling for this class of missions.

The Other Side of Caring: Adult Children with Mental Illness as Supports to Their Mothers in Later Life.

ERIC Educational Resources Information Center

Greenberg, Jan Steven

1995-01-01

Discusses the role of adult children with serious mental illness as a source of support to their aging parents. Most mothers reported that their mentally-ill children provided at least some ongoing help with daily living tasks. The adult child's assistance related significantly to lower levels of maternal subjective burden. (RJM)

Rurality and Resilience in Education: Place-Based Partnerships and Agency to Moderate Time and Space Constraints

ERIC Educational Resources Information Center

Ebersohn, Liesel; Ferreira, Ronel

2012-01-01

In an ongoing longitudinal intervention study (STAR) we found that, although similarities existed in the way teachers promoted resilience, rural schools (in comparison to other STAR case schools) took longer to implement strategies to buoy support and found it difficult to sustain such support. Using rurality we wanted to understand how forces,…

Weighting issues in recreation research and in identifying support for resource conservation management alternatives

Treesearch

Amy L. Sheaffer; Jay Beaman; Joseph T. O' Leary; Rebecca L. Williams; Doran M. Mason

2001-01-01

Sampling for research in recreation settings in an ongoing challenge. Often certain groups of users are more likely to be sampled. It is important in measuring public support for resource conservation and in understanding use of natural resources for recreation to evaluate issues of bias in survey methodologies. Important methodological issues emerged from a statewide...

76 FR 2163 - Self-Regulatory Organizations; Notice of Filing and Immediate Effectiveness of Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-12

..., Inc. Establishing Fees for Support and Maintenance of the Trading Floor, and Fees To Defray the Costs... proposes to establish fees for support and maintenance of the Trading Floor, and fees to defray the costs... Maker on the floor. The fee will be assessed to recover ongoing costs associated with the Trading Floor...

"Reaching Every Student" with a Pyramid of Intervention Approach: One District's Journey

ERIC Educational Resources Information Center

Howery, Kathy; McClellan, Tony; Pedersen-Bayus, Karen

2013-01-01

This paper presents a description of ongoing work of an Alberta school district that is working to support and enhance effective inclusive practices that reach and teach every student. The district is implementing a Pyramid of Supports model that is built upon four critical elements: a belief in social justice and the value of every child, a…

Resilience in Midwestern Families: Selected Findings from the First Decade of a Prospective, Longitudinal Study.

ERIC Educational Resources Information Center

Conger, Rand D.; Conger, Katherine J.

2002-01-01

An ongoing longitudinal study of 558 focal youth and families was used to review mechanisms of resilience. Findings demonstrated how resilience to economic adversity for families was promoted by marital support, effective problem solving, and a sense of mastery. For youth, resilience was promoted by support from parents, sibling, and other adults.…

Coaching: The Key to Translating Research into Practice Lies in Continuous, Job-Embedded Learning with Ongoing Support

ERIC Educational Resources Information Center

Knight, Jim

2009-01-01

In the past decade, interest in the form of professional learning loosely described as coaching has exploded. This growing interest in coaching is likely fueled by educators' recognition that traditional one-shot approaches to professional development--where teachers hear about practices but do not receive follow-up support--are ineffective at…

Direct Write Printing on Thin and Flexible Substrates for Space Applications

NASA Technical Reports Server (NTRS)

Paquette, Beth

2016-01-01

This presentation describes the work done on direct-write printing conductive traces for a flexible detector application. A Repeatability Plan was established to define detector requirements, material and printer selections, printing facilities, and tests to verify requirements are met. Designs were created for the detector, and printed using an aerosol jet printer. Testing for requirement verification is ongoing.

45 CFR 309.135 - What requirements apply to funding, obligating and liquidating Federal title IV-D grant funds?

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 2 2011-10-01 2011-10-01 false What requirements apply to funding, obligating and... (IV-D) PROGRAM Tribal IV-D Program Funding § 309.135 What requirements apply to funding, obligating and liquidating Federal title IV-D grant funds? (a) Funding period—(1) Ongoing funding. Federal title...

45 CFR 309.135 - What requirements apply to funding, obligating and liquidating Federal title IV-D grant funds?

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 2 2012-10-01 2012-10-01 false What requirements apply to funding, obligating and... (IV-D) PROGRAM Tribal IV-D Program Funding § 309.135 What requirements apply to funding, obligating and liquidating Federal title IV-D grant funds? (a) Funding period—(1) Ongoing funding. Federal title...

45 CFR 309.135 - What requirements apply to funding, obligating and liquidating Federal title IV-D grant funds?

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 2 2014-10-01 2012-10-01 true What requirements apply to funding, obligating and... (IV-D) PROGRAM Tribal IV-D Program Funding § 309.135 What requirements apply to funding, obligating and liquidating Federal title IV-D grant funds? (a) Funding period—(1) Ongoing funding. Federal title...

45 CFR 309.135 - What requirements apply to funding, obligating and liquidating Federal title IV-D grant funds?

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 2 2013-10-01 2012-10-01 true What requirements apply to funding, obligating and... (IV-D) PROGRAM Tribal IV-D Program Funding § 309.135 What requirements apply to funding, obligating and liquidating Federal title IV-D grant funds? (a) Funding period—(1) Ongoing funding. Federal title...

45 CFR 309.135 - What requirements apply to funding, obligating and liquidating Federal title IV-D grant funds?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false What requirements apply to funding, obligating and... (IV-D) PROGRAM Tribal IV-D Program Funding § 309.135 What requirements apply to funding, obligating and liquidating Federal title IV-D grant funds? (a) Funding period—(1) Ongoing funding. Federal title...

Telemedicine Support Groups for Home Parenteral Nutrition Users.

PubMed

Nelson, Eve-Lynn; Yadrich, Donna Macan; Thompson, Noreen; Wright, Shawna; Stone, Kathaleen; Adams, Natasia; Werkowitch, Marilyn; Smith, Carol E

2017-12-01

Patients receiving home parenteral nutrition (HPN), a life-sustaining intravenous (IV) infusion that provides nourishment and hydration to patients with short gut or inflammatory bowel diseases, are often isolated and not in visual contact with peers or health providers. One completed clinical trial (Clinical Trials.gov NCT0190028) and 1 ongoing clinical trial (Clinical Trials.gov NCT02987569) are evaluating a mobile videoconferencing-delivered support group intervention for patients on HPN and their caregivers. This home-based telemedicine intervention uses encrypted tablet-based videoconferencing to connect multiple families in real time. The twice-daily IV regimen is challenging for patients who may experience infusion catheter-related bloodstream infections, difficulties with fatigue, loss of sleep, depressive disorders, and worry over the potential life-threatening side effects and the expenses of this therapy. Using secure telemedicine, the facilitated support group intervention aims to enhance HPN home care, daily functioning, and quality of life. The authors provide the rationale for the telemedicine approach with HPN users and caregivers. They provide "how-to" information about the content and process of the facilitated support group sessions via secure videoconferencing. They share lessons learned from the ongoing evaluation of the telemedicine approach.

Tying eHealth Tools to Patient Needs: Exploring the Use of eHealth for Community-Dwelling Patients With Complex Chronic Disease and Disability

PubMed Central

Miller, Daniel; Kuluski, Kerry; Cott, Cheryl

2014-01-01

Background Health policy makers have recently shifted attention towards examining high users of health care, in particular patients with complex chronic disease and disability (CCDD) characterized as having multimorbidities and care needs that require ongoing use of services. The adoption of eHealth technologies may be a key strategy in supporting and providing care for these patients; however, these technologies need to address the specific needs of patients with CCDD. This paper describes the first phase of a multiphased patient-centered research project aimed at developing eHealth technology for patients with CCDD. Objective As part of the development of new eHealth technologies to support patients with CCDD in primary care settings, we sought to determine the perceived needs of these patients with respect to (1) the kinds of health and health service issues that are important to them, (2) the information that should be collected and how it could be collected in order to help meet their needs, and (3) their views on the challenges/barriers to using eHealth mobile apps to collect the information. Methods Focus groups were conducted with community-dwelling patients with CCDD and caregivers. An interpretive description research design was used to identify the perceived needs of participants and the information sharing and eHealth technologies that could support those needs. Analysis was conducted concurrently with data collection. Coding of transcripts from four focus groups was conducted by 3 authors. QSR NVivo 10 software was used to manage coding. Results There were 14 total participants in the focus groups. The average age of participants was 64.4 years; 9 participants were female, and 11 were born in Canada. Participants identified a need for open two-way communication and dialogue between themselves and their providers, and better information sharing between providers in order to support continuity and coordination of care. Access issues were mainly around wait times for appointments, challenges with transportation, and costs. A visual depiction of these perceived needs and their relation to each other is included as part of the discussion, which will be used to guide development of our eHealth technologies. Participants recognized the potential for eHealth technologies to support and improve their care but also expressed common concerns regarding their adoption. Specifically, they mentioned privacy and data security, accessibility, the loss of necessary visits, increased social isolation, provider burden, downloading responsibility onto patients for care management, entry errors, training requirements, and potentially confusing interfaces. Conclusions From the perspective of our participants, there is a significant potential for eHealth tools to support patients with CCDD in community and primary care settings, but we need to be wary of the potential downfalls of adopting eHealth technologies and pay special attention to patient-identified needs and concerns. eHealth tools that support ongoing patient-provider interaction, patient self-management (such as telemonitoring), and provider-provider interactions (through electronic health record integration) could be of most benefit to patients similar to those in our study. PMID:25428028

"It Takes a Network": Building National Capacity for Climate Change Interpretation

NASA Astrophysics Data System (ADS)

Spitzer, W.

2014-12-01

Since 2007, the New England Aquarium has led a national effort to increase the capacity of informal science venues to effectively communicate about climate change. We are now leading the NSF-funded National Network for Ocean and Climate Change Interpretation (NNOCCI), partnering with the Association of Zoos and Aquariums, FrameWorks Institute, Woods Hole Oceanographic Institution, Monterey Bay Aquarium, and National Aquarium, with evaluation conducted by the New Knowledge Organization, Pennsylvania State University, and Ohio State University. More than 1,500 informal science venues (science centers, museums, aquariums, zoos, nature centers, national parks) are visited annually by 61% of the U.S. population. These visitors expect reliable information about environmental issues and solutions. NNOCCI enables teams of informal science interpreters across the country to serve as "communication strategists" - beyond merely conveying information they can influence public perceptions, given their high level of commitment, knowledge, public trust, social networks, and visitor contact. Beyond providing in-depth training, we have found that our "alumni network" is assuming an increasingly important role in achieving our goals: 1. Ongoing learning - Training must be ongoing given continuous advances in climate and social science research. 2. Implementation support - Social support is critical as interpreters move from learning to practice, given complex and potentially contentious subject matter. 3. Leadership development - We rely on a national cadre of interpretive leaders to conduct workshops, facilitate study circle trainings, and support alumni. 4. Coalition building - A peer network helps to build and maintain connections with colleagues, and supports further dissemination through the informal science community. We are experimenting with a variety of online and face to face strategies to support the growing alumni network. Our goals are to achieve a systemic national impact, embed our work within multiple ongoing regional and national climate change education networks, and leave an enduring legacy.

Cloud-based crowd sensing: a framework for location-based crowd analyzer and advisor

NASA Astrophysics Data System (ADS)

Aishwarya, K. C.; Nambi, A.; Hudson, S.; Nadesh, R. K.

2017-11-01

Cloud computing is an emerging field of computer science to integrate and explore large and powerful computing systems and storages for personal and also for enterprise requirements. Mobile Cloud Computing is the inheritance of this concept towards mobile hand-held devices. Crowdsensing, or to be precise, Mobile Crowdsensing is the process of sharing resources from an available group of mobile handheld devices that support sharing of different resources such as data, memory and bandwidth to perform a single task for collective reasons. In this paper, we propose a framework to use Crowdsensing and perform a crowd analyzer and advisor whether the user can go to the place or not. This is an ongoing research and is a new concept to which the direction of cloud computing has shifted and is viable for more expansion in the near future.

How to introduce a program of Enhanced Recovery after Surgery? The experience of the CAPIO group.

PubMed

Verrier, J-F; Paget, C; Perlier, F; Demesmay, F

2016-12-01

The traditional model of hospital care has been challenged by the development of a care-management process that allows early patient autonomy (outpatient surgery, Enhanced Recovery after Surgery). Hospitalization has been transformed in response to this development, based on innovative medical and organizational strategies. Within a surgical service, the deployment of these processes requires the creation of a support structure, with re-organization of existing structures, analysis of potential obstacles, implementation of management tools, and ongoing follow-up of organizational function, clinical results, organizational and patient satisfaction. These will ultimately assess adaptation of structures within these new organizations. In this article, we share our insights based on experience gained over the past six years by surgical teams of the CAPIO group. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Involvement of the European Confederation of the Soil Science Societies in soil protection policy development

NASA Astrophysics Data System (ADS)

Boivin, Pascal

2017-04-01

The European Confederation of the Soil Science Societies (ECSSS) was founded not only to organize the Eurosoil congress, but also to continuously support and promote the soil causes in the European area. A work is in progress to define the best way to achieve this goal, with integrating voices of the European structures and networks, and the national societies. One of the major objectives is to develop a modern approach of soil protection, including leading experimentations shared with all the members, and active lobbying. Such an approach requires the buildup of an efficient interface with policy makers, stake holders, engineering and science, which should be concretized in a new the dimension of the Eurosoil congress. This communication will sketch the on-going work, with reviewing the perspectives, conditions, strengths, questions and difficulties identified.

An Introduction to Intelligent Processing Programs Developed by the Air Force Manufacturing Technology Directorate

NASA Technical Reports Server (NTRS)

Sampson, Paul G.; Sny, Linda C.

1992-01-01

The Air Force has numerous on-going manufacturing and integration development programs (machine tools, composites, metals, assembly, and electronics) which are instrumental in improving productivity in the aerospace industry, but more importantly, have identified strategies and technologies required for the integration of advanced processing equipment. An introduction to four current Air Force Manufacturing Technology Directorate (ManTech) manufacturing areas is provided. Research is being carried out in the following areas: (1) machining initiatives for aerospace subcontractors which provide for advanced technology and innovative manufacturing strategies to increase the capabilities of small shops; (2) innovative approaches to advance machine tool products and manufacturing processes; (3) innovative approaches to advance sensors for process control in machine tools; and (4) efforts currently underway to develop, with the support of industry, the Next Generation Workstation/Machine Controller (Low-End Controller Task).

Standardized network order sets in rural Ontario: a follow-up report on successes and sustainability.

PubMed

Rawn, Andrea; Wilson, Katrina

2011-01-01

Unifying, implementing and sustaining a large order set project requires strategic placement of key organizational professionals to provide ongoing user education, communication and support. This article will outline the successful strategies implemented by the Grey Bruce Health Network, Evidence-Based Care Program to reduce length of stay, increase patient satisfaction and increase the use of best practices resulting in quality outcomes, safer practice and better allocation of resources by using standardized Order Sets within a network of 11 hospital sites. Audits conducted in 2007 and again in 2008 revealed a reduced length of stay of 0.96 in-patient days when order sets were used on admission and readmission for the same or a related diagnosis within one month decreased from 5.5% without order sets to 3.5% with order sets.

"Who's gonna plant the trees?!?": Creating effective synergies between community and research goals in scientist-community partnerships

NASA Astrophysics Data System (ADS)

Declet-Barreto, J.; Johnson, C.

2017-12-01

Harnessing science into effective, community-focused action requires ongoing partnerships that increase both understanding and trust between communities and scientists. One hurdle to overcome is that often, research questions and goals do not line up with the most pressing perceived or objective issues that a partner community faces. Another barrier is that community members often do not have a clear idea of how communities could benefit from the research, an issue that can create confusion and undermine community support for a partnership. In this session, we will discuss some of our successes and misses in developing research partnerships and actionable science for the benefit of communities. We will share stories on how we crafted effective actionable research products in partnership with Environmental Justice and other vulnerable communities.

Harmful Effects of Hyperoxia in Postcardiac Arrest, Sepsis, Traumatic Brain Injury, or Stroke: The Importance of Individualized Oxygen Therapy in Critically Ill Patients.

PubMed

Vincent, Jean-Louis; Taccone, Fabio Silvio; He, Xinrong

2017-01-01

The beneficial effects of oxygen are widely known, but the potentially harmful effects of high oxygenation concentrations in blood and tissues have been less widely discussed. Providing supplementary oxygen can increase oxygen delivery in hypoxaemic patients, thus supporting cell function and metabolism and limiting organ dysfunction, but, in patients who are not hypoxaemic, supplemental oxygen will increase oxygen concentrations into nonphysiological hyperoxaemic ranges and may be associated with harmful effects. Here, we discuss the potentially harmful effects of hyperoxaemia in various groups of critically ill patients, including postcardiac arrest, traumatic brain injury or stroke, and sepsis. In all these groups, there is evidence that hyperoxia can be harmful and that oxygen prescription should be individualized according to repeated assessment of ongoing oxygen requirements.

NIITEK-NVESD AMDS program and interim field-ready system

NASA Astrophysics Data System (ADS)

Hibbard, Mark W.; Etebari, Ali

2010-04-01

NIITEK (Non-Intrusive Inspection Technology, Inc) develops and fields vehicle-mounted mine and buried threat detection systems. Since 2003, the NIITEK has developed and tested a remote robot-mounted mine detection system for use in the NVESD AMDS program. This paper will discuss the road map of development since the outset of the program, including transition from a data collection platform towards a militarized field-ready system for immediate use as a remote countermine and buried threat detection solution with real-time autonomous threat classification. The detection system payload has been integrated on both the iRobot Packbot and the Foster-Miller Talon robot. This brief will discuss the requirements for a successful near-term system, the progressive development of the system, our current real-time capabilities, and our planned upgrades for moving into and supporting field testing, evaluation, and ongoing operation.

Adolescence as a critical stage in the MCH Life Course Model: commentary for the Leadership Education in Adolescent Health (LEAH) interdisciplinary training program projects.

PubMed

Shlafer, Rebecca; Hergenroeder, Albert C; Jean Emans, S; Rickert, Vaughn I; Adger, Hoover; Spear, Bonnie; Irwin, Charles E; Kreipe, Richard E; Walker, Leslie R; Resnick, Michael D

2014-02-01

The Life Course Perspective (LCP), or Model, is now a guiding framework in Maternal and Child Health (MCH) activities, including training, supported by the Health Resources and Services Administration's Maternal and Child Health Bureau. As generally applied, the LCP tends to focus on pre- through post-natal stages, infancy and early childhood, with less attention paid to adolescents as either the "maternal" or "child" elements of MCH discourse. Adolescence is a distinct developmental period with unique opportunities for the development of health, competence and capacity and not merely a transitional phase between childhood and adulthood. Adequately addressing adolescents' emergent and ongoing health needs requires well-trained and specialized professionals who recognize the unique role of this developmental period in the LCP.

NASA Human Spaceflight Architecture Team: Lunar Surface Exploration Strategies

NASA Technical Reports Server (NTRS)

Mueller, Rob P.

2012-01-01

NASA s agency wide Human Spaceflight Architecture Team (HAT) has been developing Design Reference Missions (DRMs) to support the ongoing effort to characterize NASA s future human exploration strategy. The DRM design effort includes specific articulations of transportation and surface elements, technologies and operations required to enable future human exploration of various destinations including the moon, Near Earth Asteroids (NEAs) and Mars as well as interim cis-lunar targets. In prior architecture studies, transportation concerns have dominated the analysis. As a result, an effort was made to study the human utilization strategy at each specific destination and the resultant impacts on the overall architecture design. In particular, this paper considers various lunar surface strategies as representative scenarios that could occur in a human lunar return, and demonstrates their alignment with the internationally developed Global Exploration Roadmap (GER).

Applications of space observations to the management and utilization of coastal fishery resources

NASA Technical Reports Server (NTRS)

Kemmerer, A. J.; Savastano, K. J.; Faller, K. H.

1977-01-01

Information needs of those concerned with the harvest and management of coastal fishery resources can be satisfied in part through applications of satellite remote sensing. Recently completed and ongoing investigations have demonstrated potentials for defining fish distribution patterns from multispectral data, monitoring fishing distribution and effort with synthetic aperture radar systems, forecasting recruitment of certain estuarine-dependent species, and tracking marine mammals. These investigations, which are reviewed in this paper, have relied on Landsat 1 and 2, Skylab-3, and Nimbus-6 supported sensors and sensors carried by aircraft and mounted on surface platforms to simulate applications from Seasat-A and other future spacecraft systems. None of the systems are operational as all were designed to identify and demonstrate applications and to aid in the specification of requirements for future spaceborne systems.

Design and implementation of an air monitoring program in support of a brownfields redevelopment program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Maisel, B.E.; Hunt, G.T.; Devaney, R.J. Jr.

EPA`s Brownfields Economic Redevelopment Initiative has sparked renewal of industrial and commercial parcels otherwise idled or under-utilized because of real or perceived environmental contamination. In certain cases, restoring such parcels to productive economic use requires a redevelopment effort protective of human health and welfare through minimizing offsite migration of environmental contaminants during cleanup, demolition and remediation activities. To support these objectives, an air monitoring program is often required as an integral element of a comprehensive brownfields redevelopment effort. This paper presents a strategic framework for design and execution of an ambient air monitoring program in support of a brownfields remediationmore » effort ongoing in Lawrence, MA. Based on site characterization, the program included sample collection and laboratory analysis of ambient air samples for polychlorinated biphenyls (PCBs), polychlorinated dibenzodioxins and polychlorinated dibenzofurans (PCDDs/PCDFs), total suspended particulate (TSP), inhalable particulate (PM10), and lead. The program included four monitoring phases, identified as background, wintertime, demolition/remediation and post-demolition. Air sampling occurred over a 16 month period during 1996--97, during which time nine sampling locations were utilized to produce approximately 1,500 ambient air samples. Following strict data review and validation procedures, ambient air data interpretation focused on the following: evaluation of upwind/downwind sample pairs, comparison of ambient levels to existing regulatory standards, relation of ambient levels to data reported in the open literature, and, determination of normal seasonal variations in existing background burden, comparison of ambient levels measured during site activity to background levels.« less

Data policy and availability supporting global change research, development, and decision-making: An information perspective

NASA Technical Reports Server (NTRS)

Carroll, Bonnie C.; Jack, Robert F.; Cotter, Gladys A.

1990-01-01

An explosion of information has created a crisis for today's information age. It has to be determined how to use the best available information sources, tools, and technology. To do this it is necessary to have leadership at the interagency level to promote a coherent information policy. It is also important to find ways to educate the users of information regarding the tools available to them. Advances in technology resulted in efforts to shift from Disciplinary and Mission-oriented Systems to Decision Support Systems and Personalized Information Systems. One such effort is being made by the Interagency Working Group on Data Management for Global Change (IAWGDMGC). Five federal agencies - the Department of Commerce (DOC), Department of Energy (DOE), National Aeronautics and Space Administration (NASA), National Library of Medicine (NLM), and Department of Defense (DOD) - have an on-going cooperative information management group, CENDI (Commerce, Energy, NASA, NLM, and Defense Information), that is meeting the challenge of coordinating and integrating their information management systems. Although it is beginning to be technically feasible to have a system with text, bibliographic, and numeric data online for the user to manipulate at the user's own workstation, it will require national recognition that the resource investment in such a system is worthwhile, in order to promote its full development. It also requires close cooperation between the producers and users of the information - that is, the research and policy community, and the information community. National resources need to be mobilized in a coordinated manner to move people into the next generation of information support systems.

Factors promoting and inhibiting sustained impact of a mental health task-shifting program for HIV providers in Ethiopia.

PubMed

Jerene, D; Biru, M; Teklu, A; Rehman, T; Ruff, A; Wissow, L

2017-01-01

Task-shifting mental health into general medical care requires more than brief provider training. Generalists need long-term support to master new skills and changes to work context are required to sustain change in the face of competing priorities. We examined program and context factors promoting sustainability of a mental health task-shifting training for hospital-based HIV providers in Ethiopia. Convergent mixed-methods quasi-experimental study. Sustained impact was measured by trained/not-trained provider differences in case detection and management 16 months following the end of formal support. Factors related to sustainability were examined through interviews with trained providers. Extent of sustained impact: Trained providers demonstrated modest but better agreement with standardized screeners (greater sensitivity with similar specificity). They were more likely to request that patients with mental health problems return to see them v. making a referral. Factors promoting sustainability (reported in semi-structured interviews): provider belief that the treatments they had learned were effective. New interactions with on-site mental health staff were a source of ongoing learning and encouragement. Factors diminishing sustainability: providers feelings of isolation when mental health partners left for work elsewhere, failure to incorporate mental health indicators into administrative data, to re-stock staff education materials, and to build formal mechanisms for generalist-mental health staff interaction. An intervention seen as feasible and effective, and promotion of relationships across professional lines, helped generalists sustain new skills. Failure to address key system context issues made use of the skills unsustainable as external supports ended.

Supporting user-defined granularities in a spatiotemporal conceptual model

USGS Publications Warehouse

Khatri, V.; Ram, S.; Snodgrass, R.T.; O'Brien, G. M.

2002-01-01

Granularities are integral to spatial and temporal data. A large number of applications require storage of facts along with their temporal and spatial context, which needs to be expressed in terms of appropriate granularities. For many real-world applications, a single granularity in the database is insufficient. In order to support any type of spatial or temporal reasoning, the semantics related to granularities needs to be embedded in the database. Specifying granularities related to facts is an important part of conceptual database design because under-specifying the granularity can restrict an application, affect the relative ordering of events and impact the topological relationships. Closely related to granularities is indeterminacy, i.e., an occurrence time or location associated with a fact that is not known exactly. In this paper, we present an ontology for spatial granularities that is a natural analog of temporal granularities. We propose an upward-compatible, annotation-based spatiotemporal conceptual model that can comprehensively capture the semantics related to spatial and temporal granularities, and indeterminacy without requiring new spatiotemporal constructs. We specify the formal semantics of this spatiotemporal conceptual model via translation to a conventional conceptual model. To underscore the practical focus of our approach, we describe an on-going case study. We apply our approach to a hydrogeologic application at the United States Geologic Survey and demonstrate that our proposed granularity-based spatiotemporal conceptual model is straightforward to use and is comprehensive.

Implementing an organised cervical screening programme in the Republic of Moldova-Stakeholder identification and engagement.

PubMed

Davies, Philip; Valuta, Diana; Cojohari, Natalia; Sancho-Garnier, Helene

2017-10-01

Successfully implementing cervical screening programmes requires them to be adapted to the local context and have broad stakeholder support. This can be achieved by actively engaging local stakeholders in planning as well as implementing the programmes. The Moldovan government started implementing an organised cervical screening programme in 2010 with the first step being stakeholder identification and engagement. This process started by contacting easily identified stakeholders with each asked to recommend others and the process continued until no new ones were identified. Stakeholders were then involved in a series of individual and group meetings over a 2-year period to build confidence and encourage progressively greater engagement. In total, 87 individuals from 46 organisations were identified. Over the 2-year process, the individual and group meetings facilitated a change in stakeholder attitudes from disinterest, to acceptance and finally to active cooperation in designing the screening programme and preparing an implementation plan that were both well adapted to the Moldovan context. Developing the broad support needed to implement cervical screening programmes required ongoing interaction with stakeholders over an extended period. This interaction allowed stakeholder concerns to be identified and addressed, progress to be demonstrated, and stakeholders to be educated about organised screening programmes so they had the knowledge to progressively take greater responsibility and ownership. Copyright © 2017 Elsevier Ltd. All rights reserved.

Diabetes Education and Support: A Must for Students With Diabetes.

PubMed

Siminerio, Linda M

2015-11-01

Ongoing diabetes self-management education and support is critical to helping youth with diabetes and their families learn about the disease, make and sustain behavioral changes, and cope with the reality of a chronic illness. Diabetes self-management education and support is best provided by a multidisciplinary team. School nurses are an important part of the student's diabetes health care team. This article highlights information and resources that school nurses can use to help support students with diabetes, their families, and other school personnel. © 2015 The Author(s).

Smartkadaster: Observing Beyond Traditional Cadastre Capabilities for Malaysia

NASA Astrophysics Data System (ADS)

Isa, M. N. Bin; Hua, T. C.; Halim, N. Z. Binti Abdul

2015-10-01

The digital age for cadastral surveying started in stages, more than 20 years ago in Malaysia and JUPEM played a vital role in its successful implementation nationwide. One of the key products of cadastral survey is cadastral maps, which provide useful information for any land information system. However, as technology evolved and simplicity is familiarised, better services are anticipated and have affected how cadastral survey information are perceived. A paradigm shift is necessary where enriched cadastral information is required for multiple usage and allow real cadastral information based services to users. On that note, JUPEM is intrigued to develop a system where National Digital Cadastral Database is value added with other geospatial information for a smart and multipurpose environment and clearly be interpreted as a decision making tool with the aids of 3D realistic spatial data, namely SmartKADASTER. The SmartKADASTER is an ongoing project developed by JUPEM with the aim to establish a realistic and SMART cadastral-based spatial analysis platform for an effective planning, decision making, enabling efficiencies and enhancing communication and management to support SMART services towards SMART City enablement in Malaysia. It is developed in phases with the Federal Territory of Putrajaya and Kuala Lumpur as the initial project implementation area. This paper provides awareness and insights of the on-going development of the project and how it could benefit potential users and stakeholders.

Experiences in Bridging the Gap between Science and Decision Making at NASA's GSFC Earth Science Data and Information Services Center (GES DISC)

NASA Technical Reports Server (NTRS)

Kempler, Steven; Teng, Bill; Friedl, Lawrence; Lynnes, Chris; Leptoukh, Gregory

2008-01-01

Recognizing the significance of NASA remote sensing Earth science data in monitoring and better understanding our planet s natural environment, NASA has implemented the Decision Support Through Earth Science Research Results program (NASA ROSES solicitations). a) This successful program has yielded several monitoring, surveillance, and decision support systems through collaborations with benefiting organizations. b) The Goddard Space Flight Center (GSFC) Earth Sciences Data and Information Services Center (GES DISC) has participated in this program on two projects (one complete, one ongoing), and has had opportune ad hoc collaborations gaining much experience in the formulation, management, development, and implementation of decision support systems utilizing NASA Earth science data. c) In addition, GES DISC s understanding of Earth science missions and resulting data and information, including data structures, data usability and interpretation, data interoperability, and information management systems, enables the GES DISC to identify challenges that come with bringing science data to decision makers. d) The purpose of this presentation is to share GES DISC decision support system project experiences in regards to system sustainability, required data quality (versus timeliness), data provider understanding of how decisions are made, and the data receivers willingness to use new types of information to make decisions, as well as other topics. In addition, defining metrics that really evaluate success will be exemplified.

Operation Joint Endeavor in Bosnia: telemedicine systems and case reports.

PubMed

Calcagni, D E; Clyburn, C A; Tomkins, G; Gilbert, G R; Cramer, T J; Lea, R K; Ehnes, S G; Zajtchuk, R

1996-01-01

For the last several years the U.S. Department of Defense (DoD) has operated a telemedicine test bed at the U.S. Army Medical Research and Material Command's Medical Advanced Technology Management Office. The goal of this test bed is to reengineer the military health service system from the most forward deployed forces to tertiary care teaching medical centers within the United States by exploiting emerging telemedicine technologies. The test bed has conducted numerous proof-of-concept telemedicine demonstrations as part of military exercises and in support of real-world troop deployments. The most ambitious of those demonstrations is Primetime III, an ongoing effort to provide telemedicine and other advanced technology support to medical units supporting Operation Joint Endeavor in Bosnia. Several of the first instances of the clinical use of the Primetime III systems are presented as case reports in this paper. These reports demonstrate capabilities and limitations of telemedicine. The Primetime III system demonstrates the technical ability to provide current telecommunications capabilities to medical units stationed in the remote, austere, difficult-to-serve environment of Bosnia. Telemedicine capabilities cannot be used without adequate training, operations, and sustainment support. Video consultations have eliminated the need for some evacuations. The system has successfully augmented the clinical capability of physicians assigned to these medical units. Fullest clinical utilization of telemedicine technologies requires adjustment of conventional clinical practice patterns.

Preventing Cervical Cancer with HPV Vaccines

Cancer.gov

Cervical cancer can be prevented with HPV vaccines. NCI-supported researchers helped establish HPV as a cause of cervical cancer. They also helped create the first HPV vaccines, were involved in the vaccine trials, and contribute to ongoing studies.

Alternative Fuel for Marine Application

DOT National Transportation Integrated Search

2012-02-29

The U.S. Maritime Administration (MARAD) is participating in the U.S. Navy's ongoing efforts to test alternative fuels for marine use by demonstrating their applicability on commercial vessels. In support of this effort, the Navy provided neat hydrot...

77 FR 60107 - Marine Mammals; File No. 17298

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-02

... a permit to collect, import, export, and receive marine mammal parts for scientific research. DATES... objective of this application is to support multiple ongoing research programs at the Mystic Aquarium... continued research on these species. [[Page 60108

Alternative methods for developing external travel survey data.

DOT National Transportation Integrated Search

2010-10-01

The Texas Department of Transportation (TxDOT) has a comprehensive on-going travel survey : program that supports the travel demand models being developed for transportation planning efforts in urban : areas throughout Texas. One component of the sur...

The benefit of individualized low-dose hCG support for high responders in GnRHa-triggered IVF/ICSI cycles.

PubMed

Huang, Chen-Yu; Shieh, Miawh-Lirng; Li, Hsin-Yang

2016-07-01

To assess the pregnancy outcome and ovarian hyperstimulation syndrome (OHSS) incidence in high responders receiving gonadotropin-releasing hormone agonist (GnRHa) trigger plus individualized support of low-dose human chorionic gonadotropin (hCG). Such support includes 500-1000 IU hCG given at trigger and, if serum estradiol (E2) dropped to below 800 pg/mL before the 6(th) day after oocyte retrieval, an additional rescue dose of 300 IU hCG. This was a retrospective study of potential high responders aged from 28 years to 40 years at a tertiary fertility center in Taiwan. By means of chart review, we assessed the pregnancy outcome and OHSS incidence in high responders receiving GnRHa trigger plus individualized low-dose hCG support. The main outcomes were measured by ongoing pregnancy rate and OHSS incidence (SPSS), in which statistical significance was determined by Chi-square test. Moderate to severe OHSS did not develop in any patient receiving GnRHa trigger plus individualized low-dose hCG support. In fact, a satisfactory ongoing pregnancy rate (46.9%) was noted in patients receiving GnRHa trigger plus individualized low-dose hCG support. Our study suggested that GnRHa trigger combined with individualized low-dose hCG support appears to be a safe approach with a satisfactory pregnancy outcome. Copyright © 2016. Published by Elsevier Taiwan LLC.

Chemical plants remain vulnerable to terrorists: a call to action.

PubMed

Lippin, Tobi Mae; McQuiston, Thomas H; Bradley-Bull, Kristin; Burns-Johnson, Toshiba; Cook, Linda; Gill, Michael L; Howard, Donna; Seymour, Thomas A; Stephens, Doug; Williams, Brian K

2006-09-01

U.S. chemical plants currently have potentially catastrophic vulnerabilities as terrorist targets. The possible consequences of these vulnerabilities echo from the tragedies of the Bhopal incident in 1984 to the terrorist attacks on 11 September 2001 and, most recently, Hurricanes Katrina and Rita. Findings from a 2004 nationwide participatory research study of 125 local union leaders at sites with very large volumes of highly hazardous chemicals suggest that voluntary efforts to achieve chemical plant security are not succeeding. Study respondents reported that companies had only infrequently taken actions that are most effective in preventing or in preparing to respond to a terrorist threat. In addition, companies reportedly often failed to involve key stakeholders, including workers, local unions, and the surrounding communities, in these efforts. The environmental health community thus has an opportunity to play a key role in advocating for and supporting improvements in prevention of and preparation for terrorist attacks. Policy-level recommendations to redress chemical site vulnerabilities and the related ongoing threats to the nation's security are as follows: a) specify detailed requirements for chemical site assessment and security ; b) mandate audit inspections supported by significant penalties for cases of noncompliance ; c) require progress toward achieving inherently safer processes, including the minimizing of storage of highly hazardous chemicals ; d) examine and require additional effective actions in prevention, emergency preparedness, and response and remediation ; e) mandate and fund the upgrading of emergency communication systems ; and f) involve workers and community members in plan creation and equip and prepare them to prevent and respond effectively to an incident.

Multi-Center Implementation of NPR 7123.1A: A Collaborative Effort

NASA Technical Reports Server (NTRS)

Hall, Phillip B.; McNelis, Nancy B.

2011-01-01

Collaboration efforts between MSFC and GRC Engineering Directorates to implement the NASA Systems Engineering (SE) Engine have expanded over the past year to include other NASA Centers. Sharing information on designing, developing, and deploying SE processes has sparked further interest based on the realization that there is relative consistency in implementing SE processes at the institutional level. This presentation will provide a status on the ongoing multi-center collaboration and provide insight into how these NPR 7123.1A SE-aligned directives are being implemented and managed to better support the needs of NASA programs and projects. NPR 7123.1A, NASA Systems Engineering Processes and Requirements, was released on March 26, 2007 to clearly articulate and establish the requirements on the implementing organization for performing, supporting, and evaluating SE activities. In early 2009, MSFC and GRC Engineering Directorates undertook a collaborative opportunity to share their research and work associated with developing, updating and revising their SE process policy to comply and align with NPR 7123.1A. The goal is to develop instructions, checklists, templates, and procedures for each of the 17 SE process requirements so that systems engineers will be a position to define work that is process-driven. Greater efficiency and more effective technical management will be achieved due to consistency and repeatability of SE process implementation across and throughout each of the NASA centers. An added benefit will be to encourage NASA centers to pursue and collaborate on joint projects as a result of using common or similar processes, methods, tools, and techniques.

Chemical Plants Remain Vulnerable to Terrorists: A Call to Action

PubMed Central

Lippin, Tobi Mae; McQuiston, Thomas H.; Bradley-Bull, Kristin; Burns-Johnson, Toshiba; Cook, Linda; Gill, Michael L.; Howard, Donna; Seymour, Thomas A.; Stephens, Doug; Williams, Brian K.

2006-01-01

U.S. chemical plants currently have potentially catastrophic vulnerabilities as terrorist targets. The possible consequences of these vulnerabilities echo from the tragedies of the Bhopal incident in 1984 to the terrorist attacks on 11 September 2001 and, most recently, Hurricanes Katrina and Rita. Findings from a 2004 nationwide participatory research study of 125 local union leaders at sites with very large volumes of highly hazardous chemicals suggest that voluntary efforts to achieve chemical plant security are not succeeding. Study respondents reported that companies had only infrequently taken actions that are most effective in preventing or in preparing to respond to a terrorist threat. In addition, companies reportedly often failed to involve key stakeholders, including workers, local unions, and the surrounding communities, in these efforts. The environmental health community thus has an opportunity to play a key role in advocating for and supporting improvements in prevention of and preparation for terrorist attacks. Policy-level recommendations to redress chemical site vulnerabilities and the related ongoing threats to the nation’s security are as follows: a) specify detailed requirements for chemical site assessment and security; b) mandate audit inspections supported by significant penalties for cases of noncompliance; c) require progress toward achieving inherently safer processes, including the minimizing of storage of highly hazardous chemicals; d) examine and require additional effective actions in prevention, emergency preparedness, and response and remediation; e) mandate and fund the upgrading of emergency communication systems; and f) involve workers and community members in plan creation and equip and prepare them to prevent and respond effectively to an incident. PMID:16966080

Sodium reduction in New Zealand requires major behaviour change.

PubMed

Lofthouse, Catherine; Te Morenga, Lisa; McLean, Rachael

2016-10-01

This pilot study examined the feasibility of adherence to a low sodium diet in a sample of healthy New Zealand adults. It also addressed whether following a low sodium diet was accompanied by changes in intakes of other nutrients that influence cardiovascular risk. Eleven healthy adults provided dietary intake data and a 24-hour urine collection at baseline and follow-up. They then received nutritional counselling based on the World Health Organization recommendation for sodium intake (<2000 mg/day) and received ongoing nutritional support while undertaking a low sodium diet for four weeks. At the end of the four-week period, participants completed a semi-structured interview that elicited participants' opinions on barriers and facilitators to following a low sodium diet and explored changes in participants' dietary habits and behaviours. Thematic analysis revealed that adherence to a low sodium diet required substantial changes to participants' usual food purchasing and preparation habits. Participants reported that lack of control over the sodium content of meals eaten away from the home, the complex and time-consuming nature of interpreting nutrition information labels, and difficulty identifying suitable snacks were barriers to adherence. Detailed meal planning and cooking from scratch, using flavour replacements, reading food labels to identify low sodium foods, receiving support from other people and receiving tailored nutrition advice were facilitators. Mean sodium intake reduced over the period, accompanied by a decrease in mean intake of total fat. These factors suggest that sodium reduction in New Zealand adults was feasible. However, considerable changes to eating behaviours were required. Copyright © 2016 Elsevier Ltd. All rights reserved.

Recommendations for Clinical Decision Support Deployment: Synthesis of a Roundtable of Medical Directors of Information Systems

PubMed Central

Jenders, Robert A.; Osheroff, Jerome A.; Sittig, Dean F.; Pifer, Eric A.; Teich, Jonathan M

2007-01-01

Background: Ample evidence exists that clinical decision support (CDS) can improve clinician performance. Nevertheless, additional evidence demonstrates that clinicians still do not perform adequately in many instances. This suggests an ongoing need for implementation of CDS, in turn prompting development of a roadmap for national action regarding CDS. Objective: Develop practical advice to aid CDS implementation in order to improve clinician performance. Method: Structured group interview during a roundtable discussion by medical directors of information systems (N = 30), with subsequent review by participants and synthesis. Results: Participant consensus was that CDS should be comprehensive and should involve techniques such as order sets and facilitated documentation as well as alerts; should be subject to ongoing feedback; and should flow from and be governed by an organization’s clinical goals. Conclusion: A structured roundtable discussion of clinicians experienced in health information technology can yield practical, consensus advice for implementation of CDS. PMID:18693858

Pre-hospital identification and post-recovery challenges of intoxication with synthetic cannabinoid containing legal high products such as 'Exodus Damnation'.

PubMed

Fitzpatrick, David; O'Meara, Patrick; Cunningham, Andrew

2016-11-01

This short report describes the case of a young adult male who had smoked a synthetic cannabinoid legal high product called 'Exodus Damnation'. The patient's presentation was atypical from that described in the literature, with hypotension and hypoxaemia. Of note was the rapid recovery after pre-hospital intervention with high-flow oxygen therapy and intravenous fluids. The patient refused on-going care, despite repeated advice to attend the Emergency Department. The distinct lack of specialist support and referral to drug treatment for this patient population, with whom ambulance services are coming into contact with increasing frequency, is reported. For those patients with the capacity to refuse on-going care, ambulance services may be in an opportune position to actively promote referral to support services for these vulnerable individuals. © The Author(s) 2016.

A web-portal for interactive data exploration, visualization, and hypothesis testing

PubMed Central

Bartsch, Hauke; Thompson, Wesley K.; Jernigan, Terry L.; Dale, Anders M.

2014-01-01

Clinical research studies generate data that need to be shared and statistically analyzed by their participating institutions. The distributed nature of research and the different domains involved present major challenges to data sharing, exploration, and visualization. The Data Portal infrastructure was developed to support ongoing research in the areas of neurocognition, imaging, and genetics. Researchers benefit from the integration of data sources across domains, the explicit representation of knowledge from domain experts, and user interfaces providing convenient access to project specific data resources and algorithms. The system provides an interactive approach to statistical analysis, data mining, and hypothesis testing over the lifetime of a study and fulfills a mandate of public sharing by integrating data sharing into a system built for active data exploration. The web-based platform removes barriers for research and supports the ongoing exploration of data. PMID:24723882

IIIB or not IIIB: a previously unanswered question.

PubMed

Thibodeau, Jennifer T; Mishkin, Joseph D; Patel, Parag C; Mammen, Pradeep P A; Markham, David W; Drazner, Mark H

2012-05-01

The term New York Heart Association (NYHA) class IIIB has been used increasingly in clinical medicine, including as an inclusion criteria for many clinical trials assessing left ventricular assist devices (LVADs). Indeed, NYHA class IIIB is incorporated in the Food and Drug Administration's approved indication for the Heartmate II. However, on review of the medical literature, we found that there is no consensus definition of NYHA class IIIB. Until the ambiguity is resolved, we suggest that this designation not be used in clinical practice or by investigators leading clinical trials assessing therapies which convey substantial risk to patients and therefore require clarity in describing the enrolled patient population. With ongoing improvements in LVADs, this therapy will increasingly be considered in patients less sick than those who require inotropic support, providing urgency to establish a consensus system of classifying such patients who nevertheless fall within the spectrum of advanced heart failure. Herein we propose a modification of the standard NYHA classification system which can be used to fill this void. Copyright © 2012 Elsevier Inc. All rights reserved.

Transportation: Destination Mars

NASA Technical Reports Server (NTRS)

Eoff, Bill

1998-01-01

As the agency space transportation lead center, Marshall Space Flight Center has been conducting transportation assessments for future robotic and human Mars missions to identify critical technologies. Five human Mars options are currently under assessment with each option including all transportation requirements from Earth to Mars and return. The primary difference for each option is the propulsion source from Earth to Mars. In case any of the options require heavy launch capability that is not currently projected as available, an in-house study has been initiated to determine the most cost effective means of providing such launch capability. This assessment is only considering launch architectures that support the overall human Mars mission cost goal of $25B. The guidelines for the launch capability study included delivery of 80 metric ton (176 KLB) payloads, 25 feet diameter x 92 feet long, to 220 nmi orbits at 28.5 degrees. The launch vehicle concept of the study was designated "Magnum" to differentiate from prior heavy launch vehicle assessments. This assessment along with the assessment of options for all transportation phases of a Mars mission are on-going.

Fluid management in the optimization of space construction

NASA Technical Reports Server (NTRS)

Snyder, Howard

1990-01-01

Fluid management impacts strongly on the optimization of space construction. Large quantities of liquids are needed for propellants and life support. The mass of propellant liquids is comparable to that required for the structures. There may be a strong dynamic interaction between the stored liquids and the space structure unless the design minimizes the interaction. The constraints of cost and time required optimization of the supply/resupply strategy. The proper selection and design of the fluid management methods for: slosh control; stratification control; acquisition; transfer; gauging; venting; dumping; contamination control; selection of tank configuration and size; the storage state and the control system can improve the entire system performance substantially. Our effort consists of building mathematical/computer models of the various fluid management methods and testing them against the available experimental data. The results of the models are used as inputs to the system operations studies. During the past year, the emphasis has been on modeling: the transfer of cryogens; sloshing and the storage configuration. The work has been intermeshed with ongoing NASA design and development studies to leverage the funds provided by the Center.

Ongoing Development of a Series Bosch Reactor System

NASA Technical Reports Server (NTRS)

Abney, Morgan B; Mansell, J. Matthew; Stanley, Christine; Edmunson, Jennifer; DuMez, Samuel J.; Chen, Kevin

2013-01-01

Future manned missions to deep space or planetary surfaces will undoubtedly incorporate highly robust, efficient, and regenerable life support systems that require minimal consumables. To meet this requirement, NASA continues to explore a Bosch-based carbon dioxide reduction system to recover oxygen from CO2. In order to improve the equivalent system mass of Bosch systems, we seek to design and test a "Series Bosch" system in which two reactors in series are optimized for the two steps of the reaction, as well as to explore the use of in situ materials as carbon deposition catalysts. Here we report recent developments in this effort including assembly and initial testing of a Reverse Water-Gas Shift reactor (RWGSr) and initial testing of two gas separation membranes. The RWGSr was sized to reduce CO2 produced by a crew of four to carbon monoxide as the first stage in a Series Bosch system. The gas separation membranes, necessary to recycle unreacted hydrogen and CO2, were similarly sized. Additionally, we report results of preliminary experiments designed to determine the catalytic properties of Martian regolith simulant for the carbon formation step.

Hand hygiene and the use of personal protective equipment.

PubMed

Wyeth, Jenny

Infection prevention and control nurses (IPCNs) have an extremely wide remit in relation to the facilitation of appropriate infection prevention and control practice within healthcare environments. In order to be effective IPCNs need to be involved at all stages of healthcare service delivery and need to form close working relationships with staff at all levels and in all departments within their organisation. The provision of the necessary facilities within the clinical environment, along with the ongoing training and support of staff are essential prerequisites to changing the behaviour of staff in order to consistently deliver effective hand hygiene and other infection prevention and control practices. Auditing of practice and the investigation of incidents enable the identification of areas of practice requiring improvement, which subsequently informs the continual development of training programmes and initiatives with a view to improving patient and staff safety. IPCNs need to be able to react swiftly to the emergence of new infectious organisms and/or evidence to identify what is required in order to ensure that staff are compliant with anticipated practice to maintain the safety of the patients in their care, themselves and their colleagues.

Semantic-Web Technology: Applications at NASA

NASA Technical Reports Server (NTRS)

Ashish, Naveen

2004-01-01

We provide a description of work at the National Aeronautics and Space Administration (NASA) on building system based on semantic-web concepts and technologies. NASA has been one of the early adopters of semantic-web technologies for practical applications. Indeed there are several ongoing 0 endeavors on building semantics based systems for use in diverse NASA domains ranging from collaborative scientific activity to accident and mishap investigation to enterprise search to scientific information gathering and integration to aviation safety decision support We provide a brief overview of many applications and ongoing work with the goal of informing the external community of these NASA endeavors.

Supporting public involvement in interview and other panels: a systematic review.

PubMed

Baxter, Susan; Clowes, Mark; Muir, Delia; Baird, Wendy; Broadway-Parkinson, Andrea; Bennett, Carole

2017-10-01

Members of the public are increasingly being invited to become members of a variety of different panels and boards. This study aimed to systematically search the literature to identify studies relating to support or training provided to members of the public who are asked to be members of an interview panel. A systematic search for published and unpublished studies was carried out from June to September 2015. The search methods included electronic database searching, reference list screening, citation searching and scrutinizing online sources. We included studies of any design including published and unpublished documents which outlined preparation or guidance relating to public participants who were members of interview panels or representatives on other types of panels or committees. Results were synthesised via narrative methods. Thirty-six documents were included in the review. Scrutiny of this literature highlighted ten areas which require consideration when including members of the public on interview panels: financial resources; clarity of role; role in the interview process; role in evaluation; training; orientation/induction; information needs; terminology; support; and other public representative needs such as timing, accessibility and support with information technology. The results of the review emphasize a range of elements that need to be fully considered when planning the involvement of public participants on interview panels. It highlights potential issues relating to the degree of involvement of public representatives in evaluating/grading decisions and the need for preparation and on-going support. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Schizophrenia—Time to Commit to Policy Change

PubMed Central

Fleischhacker, W. Wolfgang

2014-01-01

Care and outcomes for people with schizophrenia have improved in recent years, but further progress is needed to help more individuals achieve an independent and fulfilled life. This report sets out the current need, informs policy makers and all relevant stakeholders who influence care quality, and supports their commitment to creating a better future. The authors recommend the following policy actions, based on research evidence, stakeholder consultation, and examples of best practice worldwide. (1) Provide an evidence-based, integrated care package for people with schizophrenia that addresses their mental and physical health needs. (2) Provide support for people with schizophrenia to enter and to remain in their community, and develop mechanisms to help guide them through the complex benefit and employment systems. (3) Provide concrete support, information, and educational programs to families and carers on how to enhance care for an individual living with schizophrenia in a manner that entails minimal disruption to their lives. (4) All stakeholders, including organizations that support people living with schizophrenia, should be consulted to regularly revise, update, and improve policy on the management of schizophrenia. (5) Provide support, which is proportionate to the impact of the disease, for research and development of new treatments. (6) Establish adequately funded, ongoing, and regular awareness-raising campaigns that form an integral part of routine plans of action. Implementation of the above recommendations will require engagement by every stakeholder, but with commitment from all, change can be achieved. PMID:24778411

Implementation of Symptom Protocols for Nurses Providing Telephone‐Based Cancer Symptom Management: A Comparative Case Study

PubMed Central

Green, Esther; Ballantyne, Barbara; Tarasuk, Joy; Skrutkowski, Myriam; Carley, Meg; Chapman, Kim; Kuziemsky, Craig; Kolari, Erin; Sabo, Brenda; Saucier, Andréanne; Shaw, Tara; Tardif, Lucie; Truant, Tracy; Cummings, Greta G.; Howell, Doris

2016-01-01

ABSTRACT Background The pan‐Canadian Oncology Symptom Triage and Remote Support (COSTaRS) team developed 13 evidence‐informed protocols for symptom management. Aim To build an effective and sustainable approach for implementing the COSTaRS protocols for nurses providing telephone‐based symptom support to cancer patients. Methods A comparative case study was guided by the Knowledge to Action Framework. Three cases were created for three Canadian oncology programs that have nurses providing telephone support. Teams of researchers and knowledge users: (a) assessed barriers and facilitators influencing protocol use, (b) adapted protocols for local use, (c) intervened to address barriers, (d) monitored use, and (e) assessed barriers and facilitators influencing sustained use. Analysis was within and across cases. Results At baseline, >85% nurses rated protocols positively but barriers were identified (64‐80% needed training). Patients and families identified similar barriers and thought protocols would enhance consistency among nurses teaching self‐management. Twenty‐two COSTaRS workshops reached 85% to 97% of targeted nurses (N = 119). Nurses felt more confident with symptom management and using the COSTaRS protocols (p < .01). Protocol adaptations addressed barriers (e.g., health records approval, creating pocket versions, distributing with telephone messages). Chart audits revealed that protocols used were documented for 11% to 47% of patient calls. Sustained use requires organizational alignment and ongoing leadership support. Linking Evidence to Action Protocol uptake was similar to trials that have evaluated tailored interventions to improve professional practice by overcoming identified barriers. Collaborating with knowledge users facilitated interpretation of findings, aided protocol adaptation, and supported implementation. Protocol implementation in nursing requires a tailored approach. A multifaceted intervention approach increased nurses’ use of evidence‐informed protocols during telephone calls with patients about symptoms. Training and other interventions improved nurses’ confidence with using COSTaRS protocols and their uptake was evident in some documented telephone calls. Protocols could be adapted for use by patients and nurses globally. PMID:27243574

Anytime, Anywhere Learning Supported by Smart Phones: Experiences and Results from the MUSIS Project

ERIC Educational Resources Information Center

Milrad, Marcelo; Spikol, Daniel

2007-01-01

In this paper we report the results of our on-going activities regarding the use of smart phones and mobile services in university classrooms. The purpose of these trials was to explore and identify which content and services could be delivered to the smart phones in order to support learning and communication in the context of university studies.…

Building Blocks: The Next Steps for Supporting Alaska's Young Children and Their Families.

ERIC Educational Resources Information Center

Alaska State Dept. of Education and Early Development, Juneau.

As part of the ongoing efforts in the state of Alaska to improve the health and well-being of the state's young children, the Alaska Departments of Education and Early Development and Health and Social Services are collaborating to develop a plan to address the critical outcomes and strategies that will support and improve the lives of Alaska's…

"We've Been through It All Together": Supports for Parents with Children with Rare Trisomy Conditions

ERIC Educational Resources Information Center

Bruns, D.; Foerster, K.

2011-01-01

Background: Parenting a child with a developmental disability can be a positive experience. A salient part of this outcome is support at the time of diagnosis and in an ongoing manner from immediate and extended family members. Studies are sparse on this topic for parents with a child with a rare trisomy condition. Method: The present study…

Trilinos I/O Support (Trios)

DOE PAGES

Oldfield, Ron A.; Sjaardema, Gregory D.; Lofstead II, Gerald F.; ...

2012-01-01

Trilinos I/O Support (Trios) is a new capability area in Trilinos that serves two important roles: (1) it provides and supports I/O libraries used by in-production scientific codes; (2) it provides a research vehicle for the evaluation and distribution of new techniques to improve I/O on advanced platforms. This paper provides a brief overview of the production-grade I/O libraries in Trios as well as some of the ongoing research efforts that contribute to the experimental libraries in Trios.

DART Support for Hurricane Matthew

NASA Image and Video Library

2016-10-13

Members of the Disaster Assessment and Recovery Team (DART) repair a section of roof atop the Operations Support Building II at NASA’s Kennedy Space Center in Florida. The effort is part of the spaceport’s ongoing recovery from Hurricane Matthew, which passed to the east of Kennedy on Oct. 6 and 7, 2016. The center received some isolated roof damage, damaged support buildings, a few downed power lines, and limited water intrusion. Beach erosion also occurred, although the storm surge was less than expected.

DART Support for Hurricane Matthew

NASA Image and Video Library

2016-10-13

Members of the Disaster Assessment and Recovery Team (DART) work on repairs to the Operations Support Building II at NASA’s Kennedy Space Center in Florida. The effort is part of the spaceport’s ongoing recovery from Hurricane Matthew, which passed to the east of Kennedy on Oct. 6 and 7, 2016. The center received some isolated roof damage, damaged support buildings, a few downed power lines, and limited water intrusion. Beach erosion also occurred, although the storm surge was less than expected.

First Choice for Energy Support. Defense Energy Support Center Fact Book, Fiscal Year 2004, Twenty-Seventh Edition

DTIC Science & Technology

2004-01-01

proceeding. UTILITY PRIVATIZATION SUPPORT Ongoing Actions FY 2004 – (Total Value - $488.1M) Fort Knox, KY – Wastewater/Stormwater Fort Monroe, VA...Iraqi civilian populace. Upon completion of the TF-RIO contracts in August 2004 , between April 2004 and August 2004 over 162,162,039 gallons of...Air Force decision to order ASTM D 975 product throughout COG 6 beginning in 2004 marked the successful completion of DESC’s automotive diesel

Onsite 40-kilowatt fuel cell power plant manufacturing and field test program

NASA Technical Reports Server (NTRS)

1985-01-01

A joint Gas Research Institute and U.S. Department of Energy Program was initiated in 1982 to evaluate the use of fuel cell power systems for on-site energy service. Forty-six 40 kW fuel cell power plants were manufactured at the United Technologies Corporation facility in South Windsor, Connecticut, and are being delivered to host utilities and other program participants in the United States and Japan for field testing. The construction of the 46 fully-integrated power plants was completed in January 1985 within the constraints of the contract plan. The program has provided significant experience in the manufacture, acceptance testing, deployment, and support of on-site fuel cell systems. Initial field test results also show that these experimental power plants meet the performance and environmental requirements of a commercial specification. This Interim Report encompasses the design and manufacturing phases of the 40 kW Power Plant Manufacturing and Field Test program. The contract between UTC and NASA also provides UTC field engineering support to the host utilities, training programs and associated manuals for utility operating and maintenance personnel, spare parts support for a defined test period, and testing at UTC of a power plant made available from a preceding program phase. These activities are ongoing and will be reported subsequently.

Forum: social network for the surveillance and prevention of workplace accidents.

PubMed

Vilela, R A G; Almeida, I M; Nunes da Silva, A; Gomes, M H P; Prado, H; Buoso, E; Dias, M D; Cavalcante, S; Lacorte, L E

2012-01-01

In 2008, academic researchers and public service officials created a university extension studies platform based on online and on-site meetings denominated "Work-Related Accidents Forum: Analysis, Prevention, and Other Relevant Aspects. Its aim was to help public agents and social partners to propagate a systemic approach that would be helpful in the surveillance and prevention of work-related accidents. This article describes and analyses such a platform. Online access is free and structured to: support dissemination of updated concepts; support on-site meetings and capacity to build educational activities; and keep a permanent space for debate among the registered participants. The desired result is the propagation of a social-technical-systemic view of work-related accidents that replaces the current traditional view that emphasizes human error and results in blaming the victims. The Forum uses an educational approach known as permanent health education, which is based on the experience and needs of workers and encourages debate among participants. The forum adopts a problematizing pedagogy that starts from the requirements and experiences of the social actors and stimulates support and discussions among them in line with an ongoing health educational approach. The current challenge is to turn the platform into a social networking website in order to broaden its links with society.

Supporting 64-bit global indices in Epetra and other Trilinos packages :

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jhurani, Chetan; Austin, Travis M.; Heroux, Michael Allen

The Trilinos Project is an effort to facilitate the design, development, integration and ongoing support of mathematical software libraries within an object-oriented framework. It is intended for large-scale, complex multiphysics engineering and scientific applications [2, 4, 3]. Epetra is one of its basic packages. It provides serial and parallel linear algebra capabilities. Before Trilinos version 11.0, released in 2012, Epetra used the C++ int data-type for storing global and local indices for degrees of freedom (DOFs). Since int is typically 32-bit, this limited the largest problem size to be smaller than approximately two billion DOFs. This was true even ifmore » a distributed memory machine could handle larger problems. We have added optional support for C++ long long data-type, which is at least 64-bit wide, for global indices. To save memory, maintain the speed of memory-bound operations, and reduce further changes to the code, the local indices are still 32-bit. We document the changes required to achieve this feature and how the new functionality can be used. We also report on the lessons learned in modifying a mature and popular package from various perspectives design goals, backward compatibility, engineering decisions, C++ language features, effects on existing users and other packages, and build integration.« less

Behavioral Health and Performance at NASA JSC: Recent Successes and Future Plan for BHP Research and Operations

NASA Technical Reports Server (NTRS)

Leveton, L. B.; VanderArk, S. T.

2014-01-01

The Behavioral Health and Performance discipline at NASA Johnson Space Center is organized into two distinct Divisions (Biomedical Research and Environmental Science Division and Space and Clinical Operations Division) but is integrated and interrelated in its day-to-day work. Ongoing operations supporting NASA's spaceflight goals benefit from the research portfolios that address risks to mission success. Similarly, these research portfolios are informed by operations to ensure investigations stay relevant given the dynamic environment of spaceflight. There are many success stories that can be presented where initial work begun as a BHP Research project, and funded through the Human Research Program, was fully implemented in operations or addressed an operational need. Examples include improving effectiveness of the debriefings used within Mission Control by the Mission Operations Directorate and countermeasures for fatigue management. There is also ongoing collaboration with research and operations for developing selection methods for future generation astronauts, and to enhance and inform the current family support function. The objective of this panel is to provide examples of recent success stories, describe areas where close collaboration is benefitting ongoing research and operations, and summarize how this will come together as NASA plans for the one year ISS mission - a unique opportunity for both BHP operations and research to learn more about preparing and supporting crewmembers for extended missions in space. The proposed panel will be comprised of six presentations, each describing a unique aspect of research or operations and the benefits to current and future spaceflight.

Supporting interruption management and multimodal interface design: three meta-analyses of task performance as a function of interrupting task modality.

PubMed

Lu, Sara A; Wickens, Christopher D; Prinet, Julie C; Hutchins, Shaun D; Sarter, Nadine; Sebok, Angelia

2013-08-01

The aim of this study was to integrate empirical data showing the effects of interrupting task modality on the performance of an ongoing visual-manual task and the interrupting task itself. The goal is to support interruption management and the design of multimodal interfaces. Multimodal interfaces have been proposed as a promising means to support interruption management.To ensure the effectiveness of this approach, their design needs to be based on an analysis of empirical data concerning the effectiveness of individual and redundant channels of information presentation. Three meta-analyses were conducted to contrast performance on an ongoing visual task and interrupting tasks as a function of interrupting task modality (auditory vs. tactile, auditory vs. visual, and single modality vs. redundant auditory-visual). In total, 68 studies were included and six moderator variables were considered. The main findings from the meta-analyses are that response times are faster for tactile interrupting tasks in case of low-urgency messages.Accuracy is higher with tactile interrupting tasks for low-complexity signals but higher with auditory interrupting tasks for high-complexity signals. Redundant auditory-visual combinations are preferable for communication tasks during high workload and with a small visual angle of separation. The three meta-analyses contribute to the knowledge base in multimodal information processing and design. They highlight the importance of moderator variables in predicting the effects of interruption task modality on ongoing and interrupting task performance. The findings from this research will help inform the design of multimodal interfaces in data-rich, event-driven domains.